Aim: To determine the epidemiological findings of acute rheumatic fever (ARF) and relationship with acute rheumatic heart disease (RHD). Patients and method: This cross sectional study was conducted from January 2012 to December 2016 (5 years) in the Department of Pediatrics. We had included patients aged from 5 to15 years old, admitted for ARF. Results: Twenty-nine black African children, 15 boys (51.7%) were included. The incidence was 5.8 cases/year. The mean age was 10.4 ± 2.7 years. The mean age of parents was 34.5 ± 6.9 years (range: 24-48) for mother and 41.2 ± 6.9 years (range: 28-56) for father. Parents were low-income 10 (34.5%), the delay of consultation was 17.7 ± 19.5 days. The medical history was: frequent pharyngitis 22 (76%), previous ARF 17 (58.6%), previous hospitalization 11 (38%). Signs were: polyarthralgia (n = 28, 96.6%), fever (n = 24, 82.8%), asthenia (n = 18, 62%), migratory polyarthritis (n = 12, 41.4%). Organic heart murmur has been reported in 13 cases (44.8%), and heart failure in 7 cases. The anomalies of blood analysis were inflammatory syndrome (100%), elevation of streptococcal enzymes (n = 27, 93%), and anemia (n = 16, 55.2%). In cardiac ultrasound, anomalies were: thickened valve (n = 13, 44.8%), mitral regurgitation (n = 13, 44.8%), dilatation of left ventricle (n = 9, 31%), aortic regurgitation (n = 5, 17.2%). The nosology of pathology was acute RHD (n = 15, 51.7%), ARF only (n = 14, 48.3%). Associated factors of acute RHD were: female sex (OR 1.52, 95%CI 0.35-6.6), low-income (OR 1.33, 95%CI 0.24-
References
[1]
Carapetis, J.R., Beaton, A., Cunningham, M.W., Guilherme, L., Karthikeyan, G., Mayosi, B.M., et al. (2016) Acute Rheumatic Fever and Rheumatic Heart Disease. Nature Reviews Disease Primers, 2, 15084. https://doi.org/10.1038/nrdp.2015.84
[2]
Gewitz, M.H., Baltimore, R.S., Tani, L.Y., Sable, C.A., Shulman, S.T., Carapetis, J., et al. (2015) Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography. A Scientific Statement from the American Heart Association. Circulation, 131, 1806-1818.
https://doi.org/10.1161/CIR.0000000000000205
[3]
Beg, A. and Sadiq, M. (2008) Subclinical Valvulitis in Children with Acute Rheumatic Fever. Pediatric Cardiology, 29, 619-623.
https://doi.org/10.1007/s00246-007-9173-0
[4]
Swain, J.D., Mucumbitsi, J., Rusingiza, E., Bolman, R.M. and Binagwaho, A. (2014) Cardiac Surgery for Advanced Rheumatic Heart Disease in Rwanda. The Lancet Global Health, 2, e141-e142. https://doi.org/10.1016/S2214-109X(14)70022-1
[5]
Yacoub, M., Mayosi, B., El Guindy, A., Carpentier, A. and Yusuf, S. (2017) Eliminating Acute Rheumatic Fever and Rheumatic Heart Disease. The Lancet, 390, 212-213. https://doi.org/10.1016/S0140-6736(17)31608-2
[6]
Abdullahi, L.H., Smit, I., Engel, M.E., Watkins, D.A. and Zühlke, L.J. (2019) Task Sharing in the Diagnosis, Prevention, and Management of Rheumatic Heart Disease. A Systematic Review. Global Heart, 14, 259-264.
https://doi.org/10.1016/j.gheart.2019.04.002
[7]
Zilla, P., Bolman, R.M., Yacoub, M.H., Beyersdorf, F., Silwa, K., Zühlke, L., et al. (2018) The Cape Town Declaration on Access to Cardiac Surgery in the Developing World. Cardiovascular Journal of Africa, 29, 256-259.
https://doi.org/10.5830/CVJA-2018-046
[8]
Mayosi, B.M. (2016) 2016 National Rheumatic Fever Week: The Status of Rheumatic Heart Disease in South Africa. South African Medical Journal, 106, 740-741.
https://doi.org/10.7196/SAMJ.2016.v106i8.11253
[9]
Mayosi, B.M., Gamra, H., Dangou, J.M. and Kasonde, J. (2014) The Challenge of Silent Rheumatic Heart Disease. The Lancet Global Health, 2, e677-e678.
https://doi.org/10.1016/S2214-109X(14)70331-6
[10]
O’Meara, W.P., Mott, J.A., Wamburu, K., Fields, B., Armstrong, J., Taylor, S.M., MacIntyre, C., et al. (2015) Etiology of Pediatric Fever in Western Kenya: A Case-Control Study of Falciparum Malaria, Respiratory Viruses, and Streptococcal Pharyngitis. American Journal Tropical Medicine Hygiene, 92, 1030-1037.
https://doi.org/10.4269/ajtmh.14-0560
[11]
Kimbally Kaky, G., Gombet, T., Voumbo, Y., Ikama Meo, S., Ellenga Mbolla, B., Mbika Cardorelle, A., et al. (2008) Rheumatic Heart Disease in Schoolchildren in Brazzaville. Medecine Tropicale, 68, 603-605.
[12]
Marijon, E., Ou, P., Celermajer, D.S., Ferreira, B., Mocumbi, A.O., Jani, D., et al. (2007) Prevalence of Rheumatic Heart Diseases Detected by Echocardiographic Screening. New England Journal of Medicine, 357, 470-476.
https://doi.org/10.1056/NEJMoa065085
[13]
Nkoke, C., Luchuo, E.B., Jingi, A.M., Makoge, C., Hamadou, B. and Dzudie, A. (2018) Rheumatic Heart Disease Awareness in the South West Region of Cameroon: A Hospital Based Survey in a Sub-Saharan African Setting. PLoS ONE, 13, e0203864. https://doi.org/10.1371/journal.pone.0203864
[14]
Murala, J.S.K., Karl, T.R. and Pezzella, A.T. (2019) Pediatric Cardiac Surgery in Low- and Middle-Income Countries: Present Status and Need for a Paradigm Shift. Frontiers in Pediatrics, 7, 214. https://doi.org/10.3389/fped.2019.00214
[15]
Republic of the Congo (2017) Report on the Analysis of Poverty in Congo. Education, Employment and Social Protection for Sustainable Poverty Reduction. World Bank Group.
http://documents.worldbank.org/curated/en/359991503510903731/pdf/114706-FRENCH-v2-Republic-of-Congo-FRE-7-17-17-M3.pdf
[16]
WHO (2011) Haemoglobin Concentration for the Diagnosis of Anaemia and the Assessment of Severity. Vitamin and Mineral Nutrition Information System. World Health Organization, Geneva.
http://www.who.int/vmnis/indicators/haemoglobin.pdf
[17]
Rasa, M., Garcia, A., Yamaga, K., Nguyen, L., Hamamura, F.D., Tam, E., et al. (2018) Hematologic and Hepatic Anomalies in Pediatric Acute Rheumatic Fever. Annals of Pediatric Research, 2, 1016.
[18]
Mayosi, B.M., Gamra, H., Dangou, J.M. and Kasonde, J. (2014) Rheumatic Heart Disease in Africa: The Mosi-O-Tinya Call to Action. The Lancet Global Health, 2, e438-e439. https://doi.org/10.1016/S2214-109X(14)70234-7
