Rheumatic heart disease in developing countries.

Published on Aug 2, 2007in The New England Journal of Medicine70.67
· DOI :10.1056/NEJMp078039
Jonathan R. Carapetis63
Estimated H-index: 63
Rheumatic fever has receded as an important health problem in wealthy countries. Dr. Jonathan Carapetis writes that for everyone else, rheumatic fever and rheumatic heart disease are bigger problems than ever and warrant urgent attention.
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Summary Acute rheumatic fever (ARF) remains a major problem in tropical regions, resource-poor countries, and minority indigenous communities. It has long been thought that group A streptococcal (GAS) pharyngitis alone was responsible for acute rheumatic fever; this belief has been supported by laboratory and epidemiological evidence gathered over more than 60 years, mainly in temperate climates where GAS skin infection is uncommon. GAS strains have been characterised as either rheumatogenic or ...
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THE prevention of recurrences of rheumatic fever depend on the protection of the patient against infection with Group A streptococci. The daily oral administration of sulfonamides or penicillin has been employed with considerable success for this purpose.1 The major limitation of continuous oral chemoprophylaxis is that patients are apt to forget to take their medication regularly. For this reason the administration of penicillin parenterally by infrequent injections may afford a more reliable m...
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Background Rheumatic heart disease (RHD) poses a high burden in low-income countries, as well as among indigenous and other socioeconomically disadvantaged populations in high-income countries. Despite its severity and preventability, RHD receives insufficient global attention and resources. We conducted a qualitative policy analysis to investigate the reasons for recent growth but ongoing inadequacy in global priority for addressing RHD. Methods and Results Drawing on social science scholarship...
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Purpose of Review Rheumatic heart disease (RHD) is a global health concern especially in low-income settings. Morbidity and mortality data from the World Health Organization (WHO) and global burden studies emphasizes on the prioritization of RHD on a global platform. Genetic, environmental, and socio-economic factors determine the sustainability and progression of RHD in various populations. In developing countries, low socioeconomic status (SES) is a vast and inevitable challenge in combating R...
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