[Prevention of rheumatic heart defects]

The study concerned the effect of incomplete or omitted secondary prophylaxis on the onset of rheumatic heart disease as well as the effect of organized secondary prophylaxis on prevention of their Appearance. Of 142 patients with rheumatic heart disease as a result of previous rheumatic fever 39 (27.5%) were on incomplete secondary prophylaxis during one year and 103 (72.5%) had no prophylaxis. As consequence of incomplete or omitted prophylaxis recurrence of rheumatic fever appeared in a high percentage (30.7 of incomplete secondary prophylaxis and 63.1% of omitted prophylaxis). Incomplete and omitted prophylaxis with frequent rheumatic fever recurrence were the main cause of the onset of rheumatic heart disease and invalidism of the Ist IInd degree. On the contrary, during organized secondary prophylaxis the following results were obtained in 224 patients with rheumatic fever (with the average follow-up of 5.8 years): no recurrence of rheumatic fever was registered in patients on regular prophylaxis; in patients on irregular prophylaxis recurrence was noted in 12.2% of patients. In 8 subjects who refused secondary prophylaxis recurrence was established was established in 50% of cases. Of 224 patients with the Ist attack of rheumatic fever during organized secondary prophylaxis rheumatic heart disease were found in 5.35% of patients and in 10% of individuals with rheumatic fever and carditis (112 cases). The organized secondary prophylaxis, introduced in Serbia in 1974, is a reliable and tested procedure in the prevention and gradual eradication of rheumatic heart disease.