Acute Rheumatic Fever In Egyptian Children: A 30- YearExperience in a Tertiary Hospital

Abstract

Acute rheumatic fever (ARF) is a leading cause of pediatric acquired heart disease amongst indigenous populations in Egypt, mainly presenting in children aged 5–15 years. This retrospective study was carried out in Tanta University Hospital, Tanta, Egypt to determine the hospital average new cases of acute rheumatic fever (ARF), and its characteristics in the past 30 years. We reviewed and retrospectively analyzed the medical records of all children hospitalized and diagnosed with ARF based on Jones criteria in Pediatric Department of Tanta University Hospitals in the period between January 1982 and December 2011. 2946 children with ARF were admitted in this period. 40.9%were admitted between 1982 and 1991, 38.86% between 1991 and 2001, and only 20.3% between 2001 and 2011. Male/female ratio was 1:1.2.The mean age at diagnosis was 9 ± 3.0 years (range 3-16). Carditis was detected in 48.9%, arthritis in 37.5 %, chorea in 4.9%, and combined lesions in 8.7%. Mitral regurgitation was the most common echocardiographic finding in patients with carditis (43.3%), isolated aortic regurgitation in (11.1%); double mitral lesion in (1.4%), mitral stenosis in (0.76 %) and aortic stenosis in only (0.34%). Over the 30-year study period, there was average of annual new cases of 98 patients/year with peaks at 1982,1986,1987 and 1991.  Although the incidence of ARF has decreased in the last decade, it still continues to be an important public health problem in Egypt, despite the progress made in the socio-economic development of the country, and is often associated with cardiac involvement.