Rheumatic heart disease in children in developing countries.

The features of rheumatic heart disease in 31 Nigerian children aged 5-11 years are presented. The majority of these children sought medical attention when they were in advanced cardiac failure. In approximately 23% of the children a past history of acute rheumatic fever was obtained. It is suggested that in developing countries, skin ulcers may be as important a focus of beta-haemolytic streptococcal infection as the throat is in developed countries in the aetiology of acute rheumatic fever. Rheumatic heart disease in developing countries present two main problems, namely, diagnosis and management including prophylaxis. The differential diagnosis of rheumatic heart disease in some tropical countries and the factors which affect the management of the disease are discussed.