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rheumatic fever prophylaxis

Nigus Zegeye, Daniel Asrat, Yimtubezinash Woldeamanuel, Abebe Habte, Etsegenet Gedlu, Tone Tønjum, Abraham Aseffa
BACKGROUND: Among children diagnosed to have chronic rheumatic valvular heart disease (RHD) in Ethiopia, many have been observed to develop recurrence of rheumatic fever (RF) despite secondary prophylaxis. This study determined the throat culture positivity rate and drug susceptibility pattern of beta hemolytic streptococci (BHS) isolated from children attending a specialized cardiac clinic in Ethiopia. METHODS: Throat swabs were collected from 233 children receiving benzathine penicillin injection as secondary prophylaxis for RHD and cultured...
September 23, 2016: BMC Infectious Diseases
Jennifer Chamberlain-Salaun, Jane Mills, Priya M Kevat, Marc G W Rémond, Graeme P Maguire
BACKGROUND: Rheumatic fever (RF) and rheumatic heart disease (RHD) cause considerable morbidity and mortality amongst Australian Aboriginal and Torres Strait Islander populations. Secondary antibiotic prophylaxis in the form of 4-weekly benzathine penicillin injections is the mainstay of control programs. Evidence suggests, however, that delivery rates of such prophylaxis are poor. METHODS: This qualitative study used semi-structured interviews with patients, parents/care givers and health professionals, to explore the enablers of and barriers to the uptake of secondary prophylaxis...
2016: BMC Cardiovascular Disorders
Himanshu Pathak, Tarnya Marshall
A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. Further investigation confirmed strongly positive streptococcal serology. There was absence of clinical or echocardiography evidence of heart involvement and immunological screening for inflammatory arthritis was negative. In the absence of other major Jones criteria for acute rheumatic fever, besides polyarthritis and the serological evidence of a recent streptococcal infection, a diagnosis of post-streptococcal reactive arthritis (PSRA) was also made...
2016: BMJ Case Reports
Rosemary Wyber, Ben J Boyd, Samantha Colquhoun, Bart J Currie, Mark Engel, Joseph Kado, Ganesan Karthikeyan, Mark Sullivan, Anita Saxena, Meru Sheel, Andrew Steer, Joseph Mucumbitsi, Liesl Zühlke, Jonathan Carapetis
Rheumatic fever is caused by an abnormal immune reaction to group A streptococcal infection. Secondary prophylaxis with antibiotics is recommended for people after their initial episode of rheumatic fever to prevent recurrent group A streptococcal infections, recurrences of rheumatic fever and progression to rheumatic heart disease. This secondary prophylaxis must be maintained for at least a decade after the last episode of rheumatic fever. Benzathine penicillin G is the first line antibiotic for secondary prophylaxis, delivered intramuscularly every 2 to 4 weeks...
October 2016: Drug Delivery and Translational Research
Esra Gurkas, Zeynep S Karalok, Birce D Taskin, Ummu Aydogmus, Alev Guven, Aydan Degerliyurt, Omer Bektas, Cahide Yilmaz
OBJECTIVE: Sydenham's chorea is the most common cause of acquired chorea in children and is the major manifestation for acute rheumatic fever. Despite being known as a benign, self-limiting condition, recurrences and persistence of symptoms can be seen. In this study, we aimed to evaluate retrospectively the clinical and laboratory features of patients with Sydenham's chorea and the rate and the course of recurrences, and to assess the risk of recurrences. METHODS: The study was a retrospective study conducted in a tertiary hospital...
October 2016: Brain & Development
A Joshi, R P B Shrestha, P S Shrestha, S Dangol, N C Shrestha, P Poudyal, A Shrestha
Sydenham's chorea is the most common type of acquired chorea in childhood which is a major neurological manifestation of rheumatic fever. We describe a 13 years old girl who presented with weakness and purposeless involuntary movements of upper and lower limbs. The symptoms slightly affected the child's daily activities and had an unstable gait on walking which was aggravated during stress. Grade II ejection systolic murmur was noticed on cardiovascular examination. Echocardiography evaluation showed thickened aortic and mitral valve leaflets with mild to moderate degree of mitral regurgitation...
July 2015: Kathmandu University Medical Journal (KUMJ)
Ayşe Güler Eroğlu
In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38...
March 2016: Türk Pediatri Arşivi
Amy Sims Sanyahumbi, Craig A Sable, Andrea Beaton, Yamikani Chimalizeni, Danielle Guffey, Mina Hosseinipour, Melissa Karlsten, Peter N Kazembe, Neil Kennedy, Charles G Minard, Daniel J Penny
: Rheumatic heart disease (RHD) is the largest cardiac cause of morbidity and mortality in the world's youth. Early detection of RHD through echocardiographic screening in asymptomatic children may identify an early stage of disease, when secondary prophylaxis has the greatest chance of stopping disease progression. Latent RHD signifies echocardiographic evidence of RHD with no known history of acute rheumatic fever and no clinical symptoms. OBJECTIVE: Determine the prevalence of latent RHD among children ages 5-16 in Lilongwe, Malawi...
March 31, 2016: Congenital Heart Disease
Liesl Zühlke, Mark E Engel, Carolina E Lemmer, Marnie van de Wall, Simpiwe Nkepu, Alet Meiring, Michael Bestawros, Bongani M Mayosi
BACKGROUND: Latent rheumatic heart disease (RHD) occurs in asymptomatic individuals with echocardiographic evidence of RHD and no history of acute rheumatic fever. The natural history of latent RHD is unclear but has important clinical and economic implications about whether these children should receive penicillin prophylaxis or not. We performed a 5-year prospective study of this question. METHODS: In August 2013 through September 2014, we conducted a follow-up study of latent RHD among school pupils using the World Heart Federation (WHF) echocardiographic criteria...
2016: BMC Cardiovascular Disorders
Marc G W Rémond, Graeme P Maguire
Despite being preventable, rheumatic heart disease (RHD) remains a significant global cause of cardiovascular disease. Echocardiographic screening for early detection of RHD has the potential to enable timely commencement of treatment (secondary prophylaxis) to halt progression to severe valvular disease. However, a number of issues remain to be addressed regarding its feasibility. The natural history of Definite RHD without a prior history of acute rheumatic fever (ARF) and Borderline RHD are both unclear...
July 2015: Transl Pediatr
Anna P Ralph, Clancy Read, Vanessa Johnston, Jessica L de Dassel, Kerstin Bycroft, Alice Mitchell, Ross S Bailie, Graeme P Maguire, Keith Edwards, Bart J Currie, Adrienne Kirby, Jonathan R Carapetis
BACKGROUND: Rheumatic heart disease (RHD), caused by acute rheumatic fever (ARF), is a major health problem in Australian Aboriginal communities. Progress in controlling RHD requires improvements in the delivery of secondary prophylaxis, which comprises regular, long-term injections of penicillin for people with ARF/RHD. METHODS/DESIGN: This trial aims to improve uptake of secondary prophylaxis among Aboriginal people with ARF/RHD to reduce progression or worsening of RHD...
2016: Trials
Mariana Mirabel, Muriel Tafflet, Baptiste Noël, Tom Parks, Olivier Axler, Jacques Robert, Marie Nadra, Gwendolyne Phelippeau, Elodie Descloux, Cécile Cazorla, Isabelle Missotte, Shirley Gervolino, Yann Barguil, Bernard Rouchon, Sylvie Laumond, Thierry Jubeau, Corinne Braunstein, Jean-Philippe Empana, Eloi Marijon, Xavier Jouven
OBJECTIVES: Rheumatic heart disease (RHD) remains the leading acquired heart disease in the young worldwide. We aimed at assessing outcomes and influencing factors in the contemporary era. METHODS: Hospital-based cohort in a high-income island nation where RHD remains endemic and the population is captive. All patients admitted with newly diagnosed RHD according to World Heart Federation echocardiographic criteria were enrolled (2005-2013). The incidence of major cardiovascular events (MACEs) including heart failure, peripheral embolism, stroke, heart valve intervention and cardiovascular death was calculated, and their determinants identified...
December 2015: Heart: Official Journal of the British Cardiac Society
S M McGlacken-Byrne, H M Parry, P F Currie, N J Wilson
Our patient is an 18-year-old Caucasian woman from the UK who developed severe mitral stenosis on a history of childhood acute rheumatic fever (ARF) and rheumatic heart disease (RHD). She had been reporting of her oral penicillin secondary prophylaxis regimen since diagnosis. At the age of 15 years, a new murmur was discovered during routine cardiac follow-up. An echocardiogram confirmed moderate-severe mitral stenosis. One year later, her exercise tolerance significantly deteriorated and she subsequently underwent balloon valvuloplasty of her mitral valve to good effect...
2015: BMJ Case Reports
P Gapu, M Bwakura-Dangarembizi, G Kandawasvika, D Kao, C Bannerman, J Hakim, J A Matenga
BACKGROUND: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain significant causes of morbidity and mortality in resource-limited settings. In Zimbabwe ARF/RHD characteristics have not been systematically documented. OBJECTIVES: To document cases of ARF/RHD among children presenting at referral hospitals in Harare, Zimbabwe, determine their clinical and echocardiographic characteristics, and identify opportunities for improving care. METHODS: A cross-sectional survey was carried out in which consecutive children aged 1 - 12 years presenting with ARF/RHD according to the 2002/3 World Health Organization modified Jones criteria were enrolled...
May 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Liat Perl, Ifat Kvint, Abraham Matitiau, Alex Levi, Judith Barash, Yosef Uziel
OBJECTIVES: Unlike rheumatic fever (RF), the association of post-streptococcal reactive arthritis (PSRA) and carditis is controversial. The American Heart Association recommends anti-streptococcal prophylaxis for PSRA for one year, repeating echocardiogram and discontinuation of prophylaxis if normal. In this study the possibility of late cardiac involvement was investigated in a cohort of children with PSRA. METHODS: Children diagnosed with PSRA and followed at the Paediatric Rheumatology Units at two medical centres in Israel had echocardiography carried out by a paediatric cardiologist, at least 1 year following diagnosis...
July 2015: Clinical and Experimental Rheumatology
Marc Rémond, David Atkinson, Andrew White, Alex Brown, Jonathan Carapetis, Bo Remenyi, Kathryn Roberts, Graeme Maguire
BACKGROUND: The World Heart Federation criteria for the echocardiographic diagnosis of rheumatic heart disease (RHD) include a category "Borderline" RHD which may represent the earliest evidence of RHD. We aimed to determine the significance of minor heart valve abnormalities, including Borderline RHD, in predicting the future risk of acute rheumatic fever (ARF) or RHD. METHODS: A prospective cohort study of Aboriginal and Torres Strait Islander children aged 8 to 18 years was conducted...
November 1, 2015: International Journal of Cardiology
Tamirat Moges, Etsegenet Gedlu, Petros Isaakidis, Ajay Kumar, Rafael Van Den Berge, Mohammed Khogali, Amha Mekasha, Sven Gudmund Hinderaker
INTRODUCTION: Infective endocarditis is an infection of the endocardial lining of the heart mainly associated with congenital and rheumatic heart disease. Although it is a rare disease in children, it is associated with high morbidity and mortality; death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. METHODS: This was a retrospective review of routinely collected data from patient records. RESULTS: A total of 40 children (71% female) with 41 episodes of infective endocarditis admitted to a general paediatric ward in Addis Ababa, Ethiopia between 2008 and 2013...
2015: Pan African Medical Journal
Amanda Beaudoin, Laura Edison, Camille E Introcaso, Lucy Goh, James Marrone, Amelita Mejia, Chris Van Beneden
Acute rheumatic fever is a nonsuppurative, immune-mediated consequence of group A streptococcal pharyngitis (strep throat). Recurrent or severe acute rheumatic fever can cause permanent cardiac valve damage and rheumatic heart disease, which increases the risk for cardiac conditions (e.g., infective endocarditis, stroke, and congestive heart failure). Antibiotics can prevent acute rheumatic fever if administered no more than 9 days after symptom onset. Long-term benzathine penicillin G (BPG) injections are effective in preventing recurrent acute rheumatic fever attacks and are recommended to be administered every 3-4 weeks for 10 years or until age 21 years to children who receive a diagnosis of acute rheumatic fever...
May 29, 2015: MMWR. Morbidity and Mortality Weekly Report
C C Azodo, P I Ojehanon
INTRODUCTION: Inappropriate antibiotics prescription in dental healthcare delivery that may result in the emergence of antibiotic-resistant bacteria, is a worldwide concern. The objective of the study was to determine the antibiotics knowledge and prescription patterns among dentists in Nigeria. MATERIALS AND METHODS: A total of 160 questionnaires were distributed to dentists attending continuing education courses organized by two organizations in Southern and Northern parts of Nigeria...
September 2014: Odonto-stomatologie Tropicale, Tropical Dental Journal
Ana Olga Mocumbi
Rheumatic heart disease (RHD) constitutes a leading cause of premature death and incapacity in Africa, where it is encountered in younger people, and shows a much faster and more malignant course than that seen in Europe or North America. While it is well established that RHD is a consequence of recurrent, untreated group A β-haemolytic streptococcal infections (GAS), the pathogenesis is incompletely understood, and the variation in natural history and phenotypes are not fully explained. In Africa patients are rarely diagnosed with acute rheumatic fever (ARF)...
March 2015: Cardiovascular Journal of Africa
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