Childhood acute rheumatic fever in Malatya region

Objective: Acute rheumatic fever is a delayed inflammatory disease that follows streptococcal infection of the throat. Rheumatic fever (RF) is the most common cause of acquired heart disease in children and young adults in the developing world. The annual incidence of RF in many poor countries is as high as 100-200 per 100 000, whereas the incidence in the industrialised world is 0.5-1/100 000. There are only a few population surveys available in Turkey for prevalence of RF.Methods: In this study, we evaluated the patients with acute rheumatic carditis, who were admitted to Paediatric Cardiology Unit of Inonu University, Faculty of Medicine from January 2007 to December 2011 and to determine the incidence of acute rheumatic fever in Malatya region. Medical records of all the patients were reviewed retrospectively. Two major criteria or one major with two minor criteria are required for diagnosis of RF according to the revised Jones criteria and WHO Study Group 2002-2003 criteria. All patients were examined by a paediatric cardiologist in our study group. Every patient had a chest X-ray, electrocardiogram (ECG) and an echocardiographic investigation. Throat culture, antistreptolysin O test, C-reactive protein and sedimentation rates were investigated for each patient.Results: During the study period, 132 patients with ARF were identified between patients admitted to the present institution. Carditis was the most common major manifestation (83.3%). It was followed by arthritis (47 %) and chorea (13.6 %) and erythema marginatum (0.8 %). The mitral valve (76.5 %) was the most common affected valve followed by the aortic valve (25.8 %). Our study showed that the incidence of rheumatic carditis is between the 42.3 and 104.8 per 100 000 from 2007 to 2011 in Malatya region.Conclusion: Most studies performed in our country don?t show the true prevalence of RF. We believe that the true incidence of RF in poor side of our country is higher than the other regions.Keywords: Rheumatic fever, carditis, Malatya