Rheumatic Fever and Rheumatic Heart Disease: A Geographic area of origin, referral rate, disease severity and outcome in patients presenting at CH Baragwanath Hospital in South Africa

  • Dr Hopewell Ntsinjana, CH Baragwanath Hospital and University of the Witwatersrand, South Africa
  • Prof Antionette Cilliers, CH Baragwanath Hospital and UniVersity of the Witwatersrand, South Africa
  • Dr Lungile Pepeta, CH Baragwanath Hospital and University of the Witwatersrand, South Africa
  • Dr Paul Adams, CH Baragwanath Hospital and University of the Witwatersrand, South Africa
  • Dr Firoza Motara, Johannesburg Hospital and the University of the WitwatersrandDr, South Africa

    • Background. Acute Rheumatic fever (ARF) and its common complication Rheumatic heart disease (RHD) remains a major cause of mortality and morbidity amongst children and young adults in the developing countries. Poor socioeconomic status is of the predisposing factors to the development of ARF. New emphasis on primary health care might have played a role in the decrease in cases presenting at our unit.

    Objective. To assess the demographics and referral rate of the patients seen at the above institution since 1993 and to evaluate whether the change in health policy in South Africa has had an impact on the picture of affected patients at presentation with regard to acute versus chronic disease including disease severity and outcome.

    Method and results. We conducted a retrospective record review of all patients seen at our institution with rheumatic fever and rheumatic heart disease for the period of January 1993 to December 2005. The total number of patients reviewed was 391 with 46% males and 54% Females. The mean age at presentation was 9.8years. There were 64% of patients originating from outside the Gauteng province and within Gauteng 70% of the patients were from the informal settlement and townships.

    Conclusion. Although there is a drop in the number of RF and RHD patients presenting to our hospital there still remains a burden to health resources due to poor socioeconomic status of certain parts of our country.