Preliminary study on acute rheumatic fever at high and low altitudes of Assir region

ABSTRACT

The objective was to study the profile of acute rheumatic fever [ARF] at high and low altitudes [hot and temperate areas respectively] with particular attention to the influence of these differences on the frequency or severity of carditis. Methodology: Thirty eight children with initial attack of ARF, diagnosed between November 1987 and July 1995, were studied. Result: Twenty seven were living at altitude, temperate climate [group-1] while 11 were living at low altitudes of Tihama, hot climate [group-2]. Twenty two were males and 16 were females. The mean age was 9.7 years. Arthritis was the commonest feature [86.8%] and carditis [68.4%] came second. Mitral regurgitation occurred in 96.2% of those with carditis, aortic regurgitation occurred in 19.2% and tricuspid regurgitation in 7.7%. Mitral stenosis and aortic stenosis were not encountered. A comparison between group-1 and group-2 showed the frequency of carditis to be 66.7% and 72.7% respectively and the frequency of severe carditis in those affected to be 27.8% and 25% respectively. Chorea, erythema marginatum and subcutaneous nodules were uncommon. The study indicates that altitude and climate may not affect the frequency nor severity of carditis