The decline of rheumatic fever: Role of medical intervention

Markowitz, Milton

doi:10.1016/s0022-3476(85)80069-x

Cited by 76 publications

(29 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[16][17][18] Poverty and illiteracy breed overcrowding, which promotes the spread of many infections which, due to ignorance and scarcity of health facilities, are often neglected until complications set in, as in RF. 15,17,18 Previous studies of the incidence of affected valves in RHD have reported the mitral valve as the most common valve affected 4,19 and this is consistent with our findings (Table 2). Unfortunately, combined MR and MS found in the majority of our children are said to favor the onset of bacterial endocarditis.…”

Section: Discussionsupporting

confidence: 92%

“…The decline in the prevalence of RHD in industrialized countries has largely been attributed to the improvement in the standard of living, 14 and the persistence of this major public health problem in developing countries is mainly due to of low social circumstances and poverty. 3,15 The low scores of education, income and occupation of the head of the family in the RHD group have previously been observed in studies of RHD prevalence. [16][17][18] Poverty and illiteracy breed overcrowding, which promotes the spread of many infections which, due to ignorance and scarcity of health facilities, are often neglected until complications set in, as in RF.…”

Section: Discussionmentioning

confidence: 77%

See 1 more Smart Citation

A Clinicoepidemiologic Study of Heart Disease in Schoolchildren of Menoufia, Egypt

Refat

Rashad

Gazar

et al. 1994

Annals of Saudi Medicine

View full text Add to dashboard Cite

This study was conducted to determine the prevalence of rheumatic heart disease (RHD) and congenital heart disease (CHD) in primary schoolchildren of Menoufia, Egypt and to study the relationship between these two problems and socioeconomic conditions. A total of 8000 children were screened for cardiac disease in their schools. Children with confirmed RHD and CHD in addition to 200 healthy children (controls) were visited at their homes to assess their social environment and other factors according to a designed questionnaire. We found prevalence rates of 3.4/1000 and 2.6/1000 for the RHD and CHD respectively. The most common cardiac defects were double mitral and pulmonary stenosis in the RHD and CHD groups respectively. Nineteen (39.6%) of the patients were diagnosed for the first time during the study. Penicillin prophylaxis was received by only four (14.8%) of the RHD children and none of the CHD children. The number of other affected siblings, increased multiparity, repeated abortion, and intake of contraceptives by mothers were significantly higher in families of the children with CHD. The proportion of illiterate, unskilled, and heavy smoking fathers was higher in the two patient groups. Family income was lowest in the RHD group, while increased crowding index and low whole social environment were significantly related to both RHD and CHD. Effective programs at the community and health service levels are needed in Menoufia to solve the problem of heart disease in schoolchildren in the immediate future.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 77%

A Clinicoepidemiologic Study of Heart Disease in Schoolchildren of Menoufia, Egypt

Refat

Rashad

Gazar

et al. 1994

Annals of Saudi Medicine

View full text Add to dashboard Cite

show abstract

“…The recent annual incidence of rheumatic fever in Grenada is 52 per 100,000 in children under the age of 15 years (13; P. K. Noah, R. Kopycinski, and B. Nelson, unpublished data; B. Nelson and G. F. Armstrong, personal communications). This incidence contrasts with an incidence of 0.6 per 100,000 in individuals in the age group of 5 to 19 years in the United States (11). The patients in Grenada are monitored through district clinics in their respective parishes to ensure compliance with prophylaxis.…”

Section: Methodsmentioning

confidence: 98%

Group A Streptococcal Antibodies in Subjects with or without Rheumatic Fever in Areas with High or Low Incidences of Rheumatic Fever

Ayoub

Nelson

Shulman

et al. 2003

Clin Vaccine Immunol

View full text Add to dashboard Cite

The levels of streptococcal antibody titers in populations with or without rheumatic fever from an area with a relatively high incidence of rheumatic fever and an area with a low incidence of this disease were compared. Streptococcal antibody titers were determined for two populations, each of which included children without rheumatic fever (nonrheumatic children) and rheumatic fever patients. The two populations were derived from two separate geographic areas, one with a high incidence of rheumatic fever (Grenada) and another with a low incidence of this disease (central Florida). The results revealed an absence of consistent differences in the geometric mean antibody titers between the nonrheumatic subjects and the rheumatic fever patients from Grenada. In the population from Grenada, the mean anti-streptolysin O and anti-DNase B titers were higher in the nonrheumatic controls (P of 0.085 and 0.029, respectively). However, the mean titer of the antibody to the group A streptococcal cell wall carbohydrate was higher in the rheumatic fever patients than in the nonrheumatic controls (P ‫؍‬ 0.047). This finding contrasted with the finding that the means of all three streptococcal antibody titers in the patients with rheumatic fever were significantly higher than those in the nonrheumatic subjects from Florida (P ‫؍‬ 0.01-<0.001). The reason for this paradoxical finding became evident when the streptococcal antibody titers of the nonrheumatic subjects from Grenada and Florida were compared, revealing significantly higher levels of all three antibodies in the nonrheumatic subjects from Grenada than in the nonrheumatic subjects from Florida (P < 0.001). These results suggest that nonrheumatic individuals in an area with a high incidence of rheumatic fever have inordinately elevated levels of streptococcal antibodies in serum. The presence of elevated streptococcal antibody titers in such a population, which probably reflects a high background prevalence of streptococcal infections, should be taken into consideration when evaluating the role of the group A streptococcus in nonpurulent complications of infections.

show abstract

“…Incidence rates ranging between 0.2 and 0.64 per 100,000 population have been reported in series from the United States. [1][2][3][4][5] However, there are little data on the incidence rates of rheumatic fever in the Middle East. 6,7 The purpose of this study is to report the incidence rate of rheumatic fever and the frequency of its manifestations among Arab children in the Eastern Province of Saudi Arabia.…”

mentioning

confidence: 99%