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Primary prevention for rheumatic Fever: progress, obstacles, and opportunities.
Liesl J Zühlke1, Ganesan Karthikeyan2
1University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Global Heart
|February 19, 2015
Summary
Preventing acute rheumatic fever and rheumatic heart disease in developing nations requires early diagnosis and antibiotic treatment of group A streptococcal pharyngitis. A comprehensive control program, including primary prevention, is crucial for managing this devastating illness.
Area of Science:
- Infectious Diseases
- Public Health
- Cardiology
Background:
- Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are serious noninfectious complications of group A streptococcal (GAS) pharyngitis.
- These conditions impose a substantial global health burden, particularly in developing countries, leading to significant mortality and morbidity.
Purpose of the Study:
- To highlight the importance of early diagnosis and antibiotic treatment of GAS pharyngitis for preventing ARF and RHD.
- To emphasize the potential of locally adapted clinical algorithms for improving diagnosis and treatment in resource-limited settings.
Main Methods:
- Review of current strategies for diagnosing and treating GAS pharyngitis in resource-poor settings.
- Evaluation of the cost-effectiveness of different treatment approaches, including a treat-all strategy versus a clinical decision rule.
Main Results:
- Intramuscular penicillin is the recommended antibiotic treatment for GAS pharyngitis in developing countries.
- A treat-all strategy with intramuscular penicillin has shown cost-effectiveness, though incorporating a clinical decision rule is still preferred.
Conclusions:
- Comprehensive prevention and control programs for ARF and RHD are essential.
- These programs should integrate primary prevention strategies to effectively combat the impact of these diseases worldwide.
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