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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objective To assess factors related to recurrence of rheumatic fever attacks among school-age children (6–12 years) in El-Mahala El-Kobra City, Gharbiya Governorate. Background Recurrent episodes of acute rheumatic fever (ARF) can lead to rheumatic heart disease with considerable morbidity and mortality in children. Patients and methods A cross-sectional study was conducted in a center for follow-up of patients with rheumatic fever and rheumatic heart diseases in El-Mahala El-Kobra City, Gharbiya Governorate. There were 237 cases aged 6–12 years attending the selected center during the years of the study (first of November 2015 to end of October 2017). All cases that attended the center for follow-up (after either single attack or recurrent attacks of rheumatic fever) were recruited in the study. Participants were interviewed using a self-designed questionnaire filled by the researcher to assess socioeconomic characteristics and family and dietary history. Laboratory investigations included erythrocyte sedimentation rate, C-reactive protein, antistreptolysin O titer, and hemoglobin percent, and also ECG and echocardiography were collected from patients' files. Conclusion There was a significant association between recurrence of rheumatic fever attacks and age of the patient, tonsillectomy, regimen of taking long-acting penicillin, and lack of adherence to treatment. Results The study revealed that among 237 studied rheumatic cases, 104 (43.9%) had recurrent attacks of ARF. The most significant factor associated with recurrent ARF was the age of the patient, negative history for tonsillectomy, a regimen of taking long-acting penicillin, and lack of adherence to its use.

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