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===Impact of Age===
===Impact of Age===
Rheumatic fever is commonly reported among age group of 5-15years<ref name="pmid8440039">{{cite journal| author=Grover A, Dhawan A, Iyengar SD, Anand IS, Wahi PL, Ganguly NK| title=Epidemiology of rheumatic fever and rheumatic heart disease in a rural community in northern India. | journal=Bull World Health Organ | year= 1993 | volume= 71 | issue= 1 | pages= 59-66 | pmid=8440039 | doi= | pmc=PMC2393425 | url= }} </ref>. [[Group A beta hemolytic streptococcus]] [[pharyngitis]] is uncommon in children less than 3 years of age, and rheumatic fever is extremely rare. Rheumatic fever among adults is less frequent and accounts for 20% of cases.
Rheumatic fever tends to affect a younger age group, generally between 5-15 years.<ref name="pmid8440039">{{cite journal| author=Grover A, Dhawan A, Iyengar SD, Anand IS, Wahi PL, Ganguly NK| title=Epidemiology of rheumatic fever and rheumatic heart disease in a rural community in northern India. | journal=Bull World Health Organ | year= 1993 | volume= 71 | issue= 1 | pages= 59-66 | pmid=8440039 | doi= | pmc=PMC2393425 | url= }} </ref> Group A beta hemolytic streptococcus [[pharyngitis]] is uncommon in children less than 3 years of age, and rheumatic fever is extremely rare. Rheumatic fever among adults is less frequent and accounts for 20% of cases.


===Impact of Gender===
===Impact of Gender===

Revision as of 19:51, 12 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Lance Christiansen, D.O.; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S. [3]; Anthony Gallo, B.S. [4]

Overview

Rheumatic fever,ountries. In countries affected by the industrial revolution, domestic living conditons became less crowded, due to the development of larger homes and families had fewer children. In addition, living conditions became, generally, more hygienic. The introduction of antibiotics, first sulfonamide in the early 1930's and then penicillin in the 1940's, further caused Streptococcus pyogenes infections to become less common and less severe in economically developed countries although they never disappeared.

Epidemiology and Demographics

Developed Countries

The incidence of rheumatic fever in countries like the USA and Canada was approximately 20-40/100,000 persons during the period 1970-1990 with rheumatic heart disease occurring sporadically. Over past two decades, the prevalence of rheumatic fever has decreased to 5-20/100,000 persons in Canada and <5/100,000 persons in the USA with no new cases of rheumatic heart disease.[1] The incidence of rheumatic fever in developed nations is low, likely due to improved hygienic standards and routine use of antibiotics for acute pharyngitis.[2]

Developing Countries

The rates of rheumatic fever and rheumatic heart diseases among developing nations have mixed trends. Recently, the incidence rate of rheumatic fever has decreased in India, China, and African countries, which is mainly attributed to improved access to medical treatment. This has led to improved survival rates even among people with rheumatic heart disease. As a result, an increase in prevalence rate has been observed.[1] Newer studies relying on echocardiography in the diagnosis of rheumatic heart disease have demonstrated that rates of subclinical carditis are up to 10x higher than that diagnosed by clinical examination.[3][4][5][6] India, Pakistan, Russia, and African countries have higher prevalence rates of rheumatic heart disease. It is estimated that approximately there are 62-78 million rheumatic heart disease patients worldwide, which could potentially result in 1.4 million deaths per year.[7][8] Occurrence of rheumatic fever is associated with low socioeconomic and over crowded conditions.

Impact of Age

Rheumatic fever tends to affect a younger age group, generally between 5-15 years.[9] Group A beta hemolytic streptococcus pharyngitis is uncommon in children less than 3 years of age, and rheumatic fever is extremely rare. Rheumatic fever among adults is less frequent and accounts for 20% of cases.

Impact of Gender

No predilection towards either gender exists. However, certain manifestations of rheumatic fever such as mitral valve prolapse (carditis) and Sydenham chorea are most often observed among females than males.[10]

References

  1. 1.0 1.1 Seckeler MD, Hoke TR (2011). "The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease". Clin Epidemiol. 3: 67–84. doi:10.2147/CLEP.S12977. PMC 3046187. PMID 21386976.
  2. Miyake CY, Gauvreau K, Tani LY, Sundel RP, Newburger JW (2007). "Characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever". Pediatrics. 120 (3): 503–8. doi:10.1542/peds.2006-3606. PMID 17766522.
  3. Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D; et al. (2007). "Prevalence of rheumatic heart disease detected by echocardiographic screening". N Engl J Med. 357 (5): 470–6. doi:10.1056/NEJMoa065085. PMID 17671255.
  4. Bhaya M, Panwar S, Beniwal R, Panwar RB (2010). "High prevalence of rheumatic heart disease detected by echocardiography in school children". Echocardiography. 27 (4): 448–53. doi:10.1111/j.1540-8175.2009.01055.x. PMID 20345448.
  5. Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A; et al. (2009). "Prevalence of rheumatic heart disease in school children of urban Lahore". Heart. 95 (5): 353–7. doi:10.1136/hrt.2008.143982. PMID 18952636.
  6. Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ; et al. (2008). "Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren". Nat Clin Pract Cardiovasc Med. 5 (7): 411–7. doi:10.1038/ncpcardio1185. PMID 18398402.
  7. Paar JA, Berrios NM, Rose JD, Cáceres M, Peña R, Pérez W; et al. (2010). "Prevalence of rheumatic heart disease in children and young adults in Nicaragua". Am J Cardiol. 105 (12): 1809–14. doi:10.1016/j.amjcard.2010.01.364. PMC 2895982. PMID 20538135.
  8. Carapetis JR, Steer AC, Mulholland EK, Weber M (2005). "The global burden of group A streptococcal diseases". Lancet Infect Dis. 5 (11): 685–94. doi:10.1016/S1473-3099(05)70267-X. PMID 16253886.
  9. Grover A, Dhawan A, Iyengar SD, Anand IS, Wahi PL, Ganguly NK (1993). "Epidemiology of rheumatic fever and rheumatic heart disease in a rural community in northern India". Bull World Health Organ. 71 (1): 59–66. PMC 2393425. PMID 8440039.
  10. Bisno AL. Rheumatic fever. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 313

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