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rheumatic fever prophylaxis

Liesl J Zühlke, Andrea Beaton, Mark E Engel, Christopher T Hugo-Hamman, Ganesan Karthikeyan, Judith M Katzenellenbogen, Ntobeko Ntusi, Anna P Ralph, Anita Saxena, Pierre R Smeesters, David Watkins, Peter Zilla, Jonathan Carapetis
Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF...
February 2017: Current Treatment Options in Cardiovascular Medicine
Diana Lennon, Philippa Anderson, Melissa Kerdemelidis, Elizabeth Farrell, Suzanne Crengle Mahi, Teuila Percival, David Jansen, Joanna Stewart
BACKGROUND: Robust evidence is lacking for community initiatives to prevent first presentation acute rheumatic fever (ARF) by group A streptococcal (GAS) pharyngitis treatment. METHODS: We measured the effect of introducing a sore throat clinic program on first presentation ARF into 61 year 1-8 schools with students aged 5-13years (population ~ 25,000) in Auckland, New Zealand. The study period was 2010-2016. A generalized linear mixed model investigated ARF rate changes before and after the staggered introduction of school clinics...
February 22, 2017: Pediatric Infectious Disease Journal
Scott Dougherty, Maziar Khorsandi, Philip Herbst
Rheumatic heart disease (RHD) is a disease of poverty, is almost entirely preventable, and is the most common cardiovascular disease worldwide in those under 25 years. RHD is caused by acute rheumatic fever (ARF) which typically results in cumulative valvular lesions that may present clinically after a number of years of subclinical disease. Therapeutic interventions, therefore, typically focus on preventing subsequent ARF episodes (with penicillin prophylaxis). However, not all patients with ARF develop symptoms and not all symptomatic cases present to a physician or are correctly diagnosed...
January 2017: Annals of Pediatric Cardiology
Priya Minaxi Kevat, Benjamin M Reeves, Alan R Ruben, Ronny Gunnarsson
BACKGROUND: Optimal delivery of regular benzathine penicillin G (BPG) injections prescribed as secondary prophylaxis for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) is vital to preventing disease morbidity and cardiac sequelae in affected pediatric and young adult populations. However, poor uptake of secondary prophylaxis remains a significant challenge to ARF/RHD control programs. OBJECTIVE: In order to facilitate better understanding of this challenge and thereby identify means to improve service delivery, this systematic literature review explored rates of adherence and factors associated with adherence to secondary prophylaxis for ARF and RHD worldwide...
January 16, 2017: Current Cardiology Reviews
Emmy Okello, Chris T Longenecker, Andrea Beaton, Moses R Kamya, Peter Lwabi
BACKGROUND: Rheumatic heart disease (RHD), the long-term consequence of rheumatic fever, accounts for most cardiovascular morbidity and mortality among young adults in developing countries. However, data on contemporary outcomes from resource constrained areas are limited. METHODS: A prospective cohort study of participants aged 5-60 years with established RHD was conducted in Kampala, Uganda, in which clinical exam, echocardiography, electrocardiography (ECG), and laboratory evaluation were done every 3 months and every 4-week benzathine penicillin prophylaxis was prescribed...
January 7, 2017: BMC Cardiovascular Disorders
L C Hung, R Nadia
A total of 39 titles related to rheumatic fever or rheumatic heart disease in Malaysia were found with online literature search dating back to their inceptions and through 2014. Additional publications from conference journals were included. Nine papers were selected based on clinical relevance and future research implications. There were no population-based studies on the incidence or prevalence of ARF or RHD. In the 1980s, the incidence of admission due to ARF ranged from 2 to 21.1 per 100 000 paediatric admission per year...
June 2016: Medical Journal of Malaysia
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...
August 12, 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...
December 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...
February 19, 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...
January 27, 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...
November 3, 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
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