RHEUMATIC FEVER IN lRANIAN CHILDREN: CLINICAL AND PREVENTIVE ASPECTS

A total of70 children aged 6 to 15 years with rheumatic fever and completed in-hospital data were reviewed from 19XX to 1993. In 5X.6% of patients this was the first attack of disease, while in 41.4'10 the episode represented a recurrence. Noncompliance of antimicrobial prophylaxis was noted in all of the subjects with recurrences. 61.4% of cases gave a previous history of sore throat, and inappropriate or inadequate antibiotics had been prescribed for all of them. Carditis had occurred in 76% of patients and 51 % of them had developed heart failure. Congestive heart failure was three times more prevalent in recurrences than in initial attacks. The study showed an urgent requirement for a national training program for all health personnel (including doctors), along with the education of healthy children, patients, and their families in order to establish effective primary and secondary prophylaxis in this area.