Related Experiment Videos
The persistent challenge of rheumatic fever in the Northern Mariana Islands
Michael D Seckeler1, Leslie L Barton, Rachel Brownstein
1Department of Pediatrics, Commonwealth Health Center, PO Box 500409 CK, Saipan, MP 96950, Northern Mariana Islands. seckeler@hotmail.com
Objectives:
Acute rheumatic fever (ARF) is a major cause of morbidity and mortality in developing nations. The objective of this study was to determine the disease burden of ARF among the indigenous and non-indigenous populations of the Northern Mariana Islands.
Methods:
This was a chart review of all pediatric outpatients seen from 1984 to 2006 with ICD-9 codes corresponding to rheumatic fever or any rheumatic cardiac sequelae. The study was set in the only comprehensive inpatient facility and only public pediatric clinic in the Northern Mariana Islands.
Results:
One hundred fifty-eight cases of ARF were identified. Age at diagnosis ranged from 2.9 to 17.1 years (median 10.6 years). Fever and carditis were the most common presenting findings. The average annualized incidence of ARF was 85.8 per 100,000 person-years for those aged 5-14 years. Sixty-six percent of patients with ARF were of Chamorro or Carolinian ancestry, despite comprising only 39% of the total population, with a combined average annualized incidence of ARF of 167 per 100,000 person-years.
Conclusions:
This is the first documentation of the incidence of pediatric ARF in the Northern Mariana Islands, delineating the large disease burden in the indigenous and other Pacific Island ethnic groups. Impediments to diagnosis and primary and secondary prevention were identified. The data provide strong support for the need for primary and secondary prevention of ARF.
Insights
Indigenous populations in the Northern Mariana Islands experience a high burden of acute rheumatic fever (ARF). This study highlights the urgent need for ARF prevention strategies in these communities.
Area of Science:
- Pediatric Rheumatology
- Epidemiology
- Public Health
Background:
- Acute rheumatic fever (ARF) is a significant cause of illness and death in developing countries.
- Understanding ARF's disease burden in specific populations is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence and disease burden of ARF in indigenous and non-indigenous pediatric populations.
- To identify disparities in ARF prevalence within the Northern Mariana Islands.
Main Methods:
- Retrospective chart review of pediatric outpatients from 1984 to 2006.
- Utilized ICD-9 codes for rheumatic fever and its cardiac sequelae.
- Data collected from the sole comprehensive inpatient facility and public pediatric clinic.
Main Results:
- Identified 158 pediatric ARF cases; median age at diagnosis was 10.6 years.
- Annualized ARF incidence was 85.8 per 100,000 person-years (ages 5-14).
- Indigenous Chamorro and Carolinian populations showed a disproportionately high incidence (167 per 100,000 person-years), representing 66% of cases despite being 39% of the population.
Conclusions:
- First documentation of pediatric ARF incidence in the Northern Mariana Islands, revealing a substantial disease burden.
- Highlighted significant disparities in ARF burden among indigenous Pacific Islander groups.
- Identified barriers to diagnosis and prevention, underscoring the critical need for ARF prevention programs.
Related Concept Videos
01:23Rheumatic Heart Disease I: Introduction
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:21Rheumatic Heart Disease III: Medical Management
01:20Rheumatic Heart Disease IV: Nursing Management
01:18Endocarditis III: Medical Management
01:26Mitral Stenosis III: Medical Management