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Acute rheumatic fever.

Kajal Hirani1, Joselyn Rwebembera2, Rachel Webb3

  • 1Wesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute Australia, Perth, WA, Australia; Department of Infectious Diseases, Perth Children's Hospital, Perth, WA, Australia; Department of General Paediatrics, Fiona Stanley Hospital, Perth, WA, Australia.

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Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are serious conditions affecting children and adolescents. Prevention strategies, including GAS vaccines and improved healthcare delivery, are key to reducing their global burden.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Cardiology

Background:

  • Acute rheumatic fever (ARF) is an autoimmune complication of Group A Streptococcus (GAS) infections in children and adolescents.
  • It can progress to rheumatic heart disease (RHD), causing significant global mortality and morbidity, particularly in disadvantaged populations.
  • RHD risk is influenced by social determinants of health and genetic factors.

Purpose of the Study:

  • To review the current understanding of ARF and RHD.
  • To highlight diagnostic advancements and therapeutic challenges.
  • To explore effective prevention strategies for reducing the global burden of ARF and RHD.

Main Methods:

  • Literature review of ARF and RHD pathophysiology, diagnosis, and management.
  • Analysis of current diagnostic criteria (2015 Jones Criteria) and emerging technologies.
  • Examination of prevention strategies, including vaccination, digital health, and healthcare delivery models.

Main Results:

  • Diagnosis relies on the 2015 Jones Criteria, with potential for revolutionised diagnostics through point-of-care testing and biomarker discovery.
  • Therapeutic progress for ARF remains limited, with ongoing research into pathophysiology.
  • Prevention strategies, including GAS vaccine development and improved healthcare access, show promise for reducing future ARF burden.

Conclusions:

  • Effective prevention, encompassing vaccination, early diagnosis, and improved healthcare delivery, is crucial for mitigating the impact of ARF and RHD.
  • Addressing social determinants of health is essential for reducing health disparities associated with these conditions.
  • Continued research into pathophysiology and diagnostics is needed to improve patient outcomes.