Rheumatic fever in Kosoava--long-term study.

OBJECTIVE

1. To present RF with all its features during more than 30 years period. 2. To compare RF features in early 80s and today 3. To stress the role of echocardiography in the diagnosis and follow-up of patients with RF and RHD.

MATERIAL AND

METHODS

Retrospective analysis of patients with RF, hospitalized at University Children's Hospital, Prishtina, between 1974-2007, aged from 5 to 16 years was conducted. The diagnosis of RF was established using history, revised Jones criteria, laboratory, chest X-ray, ECG and echocardiography.

RESULTS

1254 children have been treated for RF during a period of 33 years. Most of patients were between eight and twelve years old. Male to female ratio was 1.2/1. Out of 1254 pts with RF, 84.6% experienced one attack, while in 15.4% of patients experienced one, two, three and more RF recurrences; So, the total number of RF episodes was over 1500. The number of patients with RF gradually decreased from 1974 till today by more than a half. RF with recurrences has also decreased. Analysis of RF during more than three decades, revealed some peaks in the occurrence of RF for every ten years, the phenomenon described also by other authors. Like rheumatic carditis, rheumatic heart disease is significantly more prevalent in the echocardiographic era in our Institution (from 2000). Among 1254 children with RF, there were 213 patients with RHD (17%). Changes in the treatment of patients with RF have been discussed as well as changes in the primary and secondary prophylaxis of RF.

CONCLUSION

Our data confirm the role of echocardiography in the diagnosis of RF, especially in cases with subclinical carditis. Despite the fact rheumatic fever has decreased in the developing countries, including our country too, the prevalence of rheumatic heart disease remains the same or have an increasing tendency.