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Do Rates of Arthritis and Chorea Predict the Incidence of Acute Rheumatic Fever?
MedLine Citation:
PMID:  21410594     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Acute rheumatic fever (ARF), a major cause of acquired heart disease worldwide, remains a significant public health problem. However, the precise incidence of ARF in Africa, where a large number of cases occur, remains unknown. We hypothesize that focused attention on non-cardiac features of ARF, namely joint manifestations and chorea, might enhance its detection in settings with limited resources. Methods: This hypothesis was tested by reviewing the medical records at Vanderbilt Children's Hospital from 1998 to 2008. In addition, an extensive literature review of published studies was performed to assess rates of joint findings or chorea in confirmed cases of ARF. Results: Fifty-nine new cases of ARF were diagnosed in children at Vanderbilt from 1998 to 2008. Of these cases, 91% presented with joint manifestations or chorea, and 80% satisfied the Jones criteria for ARF. These findings are consistent with literature published from our region and internationally. Conclusions: Most patients presenting with ARF have either joint symptoms or chorea, features that could be recognized by community health workers and individuals with limited medical training. The referral of patients presenting with these manifestations for further evaluation might improve detection rates of ARF in resource limited countries and lead to improved estimates of disease burden.
Authors:
Robert D Tunks; Mario A Rojas; Kathryn M Edwards; Michael R Liske
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-15
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  -     ISSN:  1442-200X     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.
Affiliation:
Monroe Carell Jr. Children's Hospital at Vanderbilt Vanderbilt University Medical Center Nashville, Tennessee Department of General Pediatrics Divisions of Pediatric Cardiology, Neonatology and Infectious Diseases.
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