A Review of Acute Rheumatic Fever and Rheumatic Heart Disease Research in Malaysia

Area of Science:

• Cardiology
• Rheumatology
• Public Health

Background:

• Rheumatic fever (ARF) and rheumatic heart disease (RHD) pose significant health challenges globally.
• Limited research exists on the epidemiology and management of ARF and RHD specifically within Malaysia.

Purpose of the Study:

• To review and synthesize existing literature on ARF and RHD in Malaysia.
• To identify research gaps and propose future research priorities.

Main Methods:

• A comprehensive literature search was conducted for publications on ARF and RHD in Malaysia up to 2014.
• Nine relevant papers were selected based on clinical relevance and research implications.
• Data on incidence, prevalence, patient demographics, and treatment were extracted and analyzed.

Main Results:

• No population-based studies on ARF or RHD incidence/prevalence were identified.
• In the 1980s, ARF admission incidence ranged from 2-21.1 per 100,000 pediatric admissions.
• RHD significantly impacts adults, with 74.5% of patients being female, predominantly in the 15-45 age group.
• Rheumatic mitral valve disease accounted for nearly half of mitral valve repairs (46.7%).
• Mitral valve interventions increased from 2010-2012, with 85.7% being repairs.
• In children with ARF, 25.4%-41.7% had a history of ARF or RHD.
• Only 44.7% of RHD patients on follow-up received recommended prophylaxis.
• A significant lack of reported history of ARF, GABHS pharyngitis, or antibiotic prophylaxis was noted in patients undergoing interventions for rheumatic mitral valve disease.

Conclusions:

• There is a critical scarcity of research on ARF and RHD in Malaysia.
• Urgent research is needed to determine incidence and prevalence, identify high-risk populations, and evaluate preventive measures.
• Establishing a surveillance system is crucial for monitoring disease progression and treatment outcomes.