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Primary Prevention for Rheumatic Fever: Progress, Obstacles, and Opportunities

Authors:

Liesl J. Zühlke ,

University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, ZA
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Ganesan Karthikeyan

Department of Cardiology, All India Institute of Medical sciences, New Delhi, IN
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Abstract

Acute rheumatic fever and rheumatic heart disease are noninfectious sequelae of group A streptococcal pharyngeal infection. These diseases represent a huge public health burden in developing countries with significant mortality and morbidity. Early diagnosis and appropriate antibiotic treatment with group A streptococcal pharyngitis provides an opportunity for prevention of acute rheumatic fever and rheumatic heart disease. The use of locally adapted clinical algorithms for diagnosing group A streptococcal pharyngitis has great potential in resource-poor settings for earlier diagnosis and early treatment. Intramuscular penicillin is the drug of choice in developing country settings. Recent work has demonstrated the cost-effectiveness of a treat-all strategy with intramuscular penicillin, whereas incorporating a clinical decision rule remains the preferred strategy. We strongly support the adoption of a comprehensive prevention and control program for acute rheumatic fever and rheumatic heart disease, incorporating primary prevention, as critical to underpinning the efforts in many parts of the world to stem the tide of this devastating disease.

How to Cite: Zühlke LJ, Karthikeyan G. Primary Prevention for Rheumatic Fever: Progress, Obstacles, and Opportunities. Global Heart. 2013;8(3):221–6. DOI: http://doi.org/10.1016/j.gheart.2013.08.005
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Published on 01 Sep 2013.
Peer Reviewed

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