How accurate is the diagnosis of rheumatic fever in Egypt? Data from the national rheumatic heart disease prevention and control program (2006-2018)

摘要

Rheumatic heart disease (RHD), a chronic sequela of acute rheumatic fever (ARF), remains the leading cause of acquired paediatric heart disease, premature death and disability in indigenous Egyptian populations. The disease affects mainly children and young adults in their most productive years, adding to the economic burden of the nation. The WHO and the Egyptian Ministry of Health and Population have jointly launched a national RHD prevention and control program in 2006, to tackle ARF and RHD at the local level. The comprehensive program provides decentralized primordial, primary, secondary and tertiary care services through 30 regional satellite centres that have been set up around the country. We analysed data of 17050 subjects evaluated through the program in El-Mahalla RHD centre over 12 years (2006 2018). The results revealed that ARF is often associated with cardiac affection and shares a similar set of risk factors in the population. However, the percentage of newly detected rheumatic cases is falling overtime albeit with increasing numbers of ARF/RHD misdiagnoses. The program is scaling-up its activities and is giving way to achieve its goals through improving social standards, intensifying community awareness, capacity building and the provision of better health care for all.