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Rheumatic fever in the Nazareth area during the last decade
G S Habib1, W R Saliba, R Mader
1Department of Internal Medicine B, Carmel Medical Center, Haifa, Israel. gshabib62@yahoo.com
The Israel Medical Association Journal : IMAJ
|July 18, 2000
Summary
Acute rheumatic fever (ARF) remains present in the Nazareth area, with arthritis as the most common symptom. This study highlights a higher mean patient age and less migratory arthritis than previously observed in ARF cases.
Area of Science:
- Rheumatology
- Epidemiology
- Public Health
Background:
- Acute rheumatic fever (ARF) is rare in developed nations.
- ARF cases occur in Israel's Nazareth area, but no recent studies exist.
- A 20-year knowledge gap on ARF in Nazareth necessitates current research.
Purpose of the Study:
- To investigate the incidence and characteristics of ARF in Nazareth over the past decade.
- To update understanding of ARF epidemiology in a developed country context.
- To provide data for potential public health interventions.
Main Methods:
- Retrospective analysis of ARF cases diagnosed by modified Jones criteria.
- Inclusion of patients from two major Nazareth hospitals covering 75% of non-obstetric emergency referrals.
- Calculation of disease incidence using hospital data and population census figures.
Main Results:
- Identified 44 ARF patients with a mean age of 18 years.
- Recorded an annual incidence rate of 5 cases per 100,000 population.
- Observed arthritis in 98% of cases (52% migratory), carditis in 34%, with rare other major manifestations.
Conclusions:
- ARF persists in the Nazareth area, contrary to its rarity in developed countries.
- The mean age of ARF patients is higher than in prior studies.
- Migratory arthritis occurred in only half of patients; other major ARF signs were infrequent.