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Rheumatic fever: clinical profile of the initial attack in India
Bulletin of the World Health Organization
|January 1, 1986
Summary
Initial attacks of rheumatic fever in developing nations are similar to those in developed countries. Congestive cardiac failure in patients with carditis is linked to continued physical activity during delayed healthcare access.
Area of Science:
- Cardiology
- Rheumatology
- Global Health
Background:
- Acute rheumatic fever (ARF) clinical presentation often differs between developed and developing countries.
- Previous studies may have conflated initial ARF attacks with recurrences, leading to skewed data.
Purpose of the Study:
- To characterize the presentation and clinical features of initial attacks of rheumatic fever.
- To compare the clinical profile of initial ARF attacks in a developing country setting with existing data from developed countries.
Main Methods:
- A prospective study of 100 carefully diagnosed initial cases of rheumatic fever.
- Detailed documentation of clinical manifestations, including carditis and congestive cardiac failure.
Main Results:
- Half of the patients presented with carditis.
- Among those with carditis, 50% experienced congestive cardiac failure.
- The clinical profile of initial ARF attacks in this developing country cohort was largely consistent with developed country data.
Conclusions:
- The high incidence of carditis and congestive cardiac failure in initial ARF attacks in developing countries may be associated with continued physical activity due to limited healthcare access.
- The clinical presentation of initial ARF attacks is similar across developed and developing countries when carefully distinguished from recurrences.