Death from Acute Rheumatic Fever in Rural Ethiopia

The Lancet: "In their Seminar, Jonathan Carapetis and colleagues (July 9, p 155)1 identify the need for more and better data on acute rheumatic fever (ARF) and rheumatic heart disease (RHD), particularly in low-income and middle-income countries. In rural Ethiopia, the prevalence of RHD in schoolchildren is about 4.6 per 10002 and recent research showed a mean age at death of 25.9 years in hospital inpatients.3
Secondary prophylaxis with a regular injection of penicillin every 3 or 4 weeks is a proven and the most cost-effective approach to the control of ARF and RHD, since primary prophylaxis is difficult to establish and vaccine development is still years away. At Dabat Health Centre in the North Gondar Administrative Zone, Ethiopia, patients with ARF and RHD have been enrolled in a follow-up and secondary prevention programme since 1998. Patients are included after seeking health care because of symptomatic ARF or RHD."