Rheumatic fever in Mahalla el-Koubra, Egypt : how accurate is the diagnosis?

الملخص EN

Objectives: Rheumatic fever still causes 25-40% of all cardiovascular disease in the world.

This study was conducted to identify some epidemiological features of rheumatic fever, the accuracy of diagnosis and the possible familial tendency of the disease and studying the sodio-demographic condition of sibling of rheumatic heart disease parents.

Methodology: a cross sectional study was conducted on 5095 persons receiving long acting penicillin for prophylaxis against rheumatic fever and 450 siblings of 229 family with history of rheumatic heart disease.

Results: Among studied persons only 36.8% were found to actually suffering from rheumatic fever either rheumatic arthritis or rheumatic heart diseases.

Females suffering rheumatic fever were 25.0%.

crowding index was significantly affecting the occurrence of the disease especially in rheumatic heart diseases.

About a quarter of patients with rheumatic arthritis and 15.1% with rheumatic heart diseases reported regular intake of Long Acting Penicillin, these differences were not statistically significant.

Rheumatic heart disease was diagnosed among 12% and rheumatic arthritis among 10% of siblings of patients with rheumatic heart disease.

Multiple analysis model show that the most contributing determinants on the occurrence of rheumatic heart diseases are the following in decreasing orders; types of medical services, age of patients, mother occupations, education of patients, and gender.

Conclusion: Misdiagnosis of rheumatic fever is still high with poor compliance with long acting penicillin which may affect efforts for prevention of rheumatic fever complications.

This reflects the implication for patients health education and awareness.

The presence of hereditary or familial tendency for rheumatic fever needs to be confirmed.