syndrome of acute rheumatic fever: up-dated

ABSTRACT

Globally RF and RHD remain the significant cause of cardiovascular diseases to day. There is a documented decrease in the incidence of ARF and in the prevalence of RHD in developed countries during the past five decades. No such a significant decrease in the prevalence of RHD in developing countries was recorded even at the beginning of the 21[st] century. RF/RHD is preventable diseases thus optimal methods of prevention and management are required. ARF is a unique non-suppurative sequel to group A streptococcal infections. Studies conducted during the last four decades clearly documented that the control of the preceding infections and their sequelae is both cost-effective and inexpensive [1]. RF and RHD are non-suppurative complications of group A streptococcal pharyngitis due to a delayed immune response[2] in a susceptible individual. It was estimated that about 15 million individuals suffered from RF/RHD worldwide[3]. The mortality rate for RHD varied from 0.5 Per 100.000 populations in Denmark to 8.2 Per 100.000 populations in China[4]. Data from developing countries suggest that mortality due to RF and RHD remains a problem and that children and young adults still die from acute RF[5].The prevalence of RF/RHD worldwide varies from 5 per 10.000 in developed countries[6] to 110/10.000 in school children in developing countries[7]. The incidence and prevalence of RF/RHD show marked variation from one country to another due to various factors related to the streptococcus, the host, the environment or any combination of them[8][9]