Naveed Akhtar, Masood Sadiq, Haseena Chagani, Asad Hafeez, Faizul Hassan Rizvi, Mehnaz Mehboob.
Guidelines for prevention of Rheumatic Fever and Rheumatic Heart Disease
Pak J Cardiol Sep - Dec 2004;15(3):136-48.
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RF and RHD cannot be separated from each other from epidemiological point of view. Recent data from Pakistan has shown a very high prevalence of RHD in both urban and rural population. In a large cross sectional survey, conducted on more than 25000 urban school going children from inner Lahore using echocardiography to confirm the cardiac lesion, has estimated a prevalence of 22/1000. Although this might be an under-estimation as prevalence rate in children who do not attend school may be higher as they tend to be more socio-economically disadvantaged and children with advanced heart disease may be unable to attend school. A study from Rahim Yar Khan is the first reliable echocardiographic data, assessing the situation of RHD in rural areas. It becomes more relevant as majority of population of Pakistan lives in the rural areas. In this study, the prevalence rate was 5.7/1000 and the other distressing aspect was that less than 20% of the patients were aware of their diagnosis and only 8% were taking rheumatic fever prophylaxis. These prevalence figures put Pakistan among the highest in the world. These observations underscore an urgent public program for prevention and control of RHD in Pakistan. As mentioned earlier that overpopulation, poverty and poor access are the major factors contributing to such high prevalence of RF/RHD in developing countries. Despite these impediments, several programs ensuring intense secondary prophylaxis and primary prevention, whenever feasible, have attained relevant decrease in mortality, prevalence, incidence, hospital admission and severity of RF/RHD. This is a review article.

Category: Cardiology
Keywords: Rheumatic Fever. Rheumatic Heart Disease.

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