Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T08:54:07.852Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute rheumatic fever in the paediatric population: a descriptive study in the Malaysian state of Sabah

Published online by Cambridge University Press:  04 May 2021

Farul R Patel Open the ORCID record for Farul R Patel [Opens in a new window] ,
Jason Wy Tan  and
Siva Rao
Farul R Patel*
Affiliation:
Department of Paediatric Cardiology, Hospital Queen Elizabeth II, Kota Kinabalu, Sabah, Malaysia
Jason Wy Tan
Affiliation:
Department of Paediatric Cardiology, Hospital Queen Elizabeth II, Kota Kinabalu, Sabah, Malaysia
Siva Rao
Affiliation:
Department of Paediatric Cardiology, Hospital Queen Elizabeth II, Kota Kinabalu, Sabah, Malaysia
*
Author for correspondence: Dr Farul R. Patel, Department of Paediatric Cardiology, Hospital Queen Elizabeth II, Lorong Bersatu, Off Jalan Damai 88300 Kota Kinabalu, Sabah, Malaysia. Tel: +6017-6738004. E-mail: farul_patel89@yahoo.com.my
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Rheumatic heart disease is among the leading causes of acquired valvular heart disease in the developing world. However, there is no data available for rheumatic heart disease in the paediatric population of Sabah. This study collected data for acute rheumatic fever admissions among the paediatric population in Sabah over a period of 3 years.

Methods:

This is a retrospective cohort study. All records for admissions to paediatric wards in Sabah for acute rheumatic fever from January 2016 to December 2018 were collected. The patient records were then traced and required information were collected.

Results:

A total of 52 cases of acute rheumatic fever were admitted. It was observed that the incidence of acute rheumatic fever was 74.4 per 100,000 paediatric admissions. Patients from the West Coast Division made up most of the admissions (n = 24, 46.2%). Male patients (n = 35, 67.3%) of the indigenous Kadazan-Dusun ethnicity (n = 21, 40.4%) were most commonly encountered. The mean age at time of presentation was 9.58 years. Most cases admitted (n = 38, 73.1%) were categorised as Priority 1 (severe rheumatic heart disease).

Conclusion:

Most patients who were admitted had symptoms of heart failure and were diagnosed with severe rheumatic heart disease. Although this disease is preventable, the incidence in Sabah remains high. This study was limited as we only looked at patients who were admitted and we foresee the real incidence to be higher. Hence, there is an urgent need for a rheumatic heart disease registry in Malaysia to gather more data for prevention and early intervention.

Keywords

Acute rheumatic feverrheumatic heart diseaseMalaysiapaediatric
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 1 , January 2022 , pp. 83 - 87
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Gururaj, AK, Choo, KE, Ariffin, WA, Sharifah, A. Clinical, laboratory and echocardiographic profile of children with acute rheumatic fever. Singapore Med J 1990; 31: 364–367.Google ScholarPubMed
Watkins, DA, Johnson, CO, Colquhoun, SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990–2015. N Engl J Med 2017; 377: 713–722. doi: 10.1056/NEJMoa1603693 CrossRefGoogle ScholarPubMed
Hassan, CH. Poverty in a Malay state in Malaysia: a socio-demographic study. SSRN Electron J 2011. doi: 10.2139/ssrn.1867885 CrossRefGoogle Scholar
Jaine, R, Baker, M, Venugopal, K. Acute rheumatic fever associated with household crowding in a developed country. Pediatr Infect Dis J 2011; 30. https://journals.lww.com/pidj/Fulltext/2011/04000/Acute_Rheumatic_Fever_Associated_With_Household.9.aspx CrossRefGoogle Scholar
Okello, E, Kakande, B, Sebatta, E, et al. Socioeconomic and environmental risk factors among rheumatic heart disease patients in Uganda. PLoS One 2012; 7: e43917–e43917. doi: 10.1371/journal.pone.0043917 CrossRefGoogle ScholarPubMed
Carapetis, JR, Brown, A, Maguire, G. The Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease, 2nd edn. RHDAustralia, Menzies School of Health Research; 2012. http://www.apsu.org.au/assets/past-studies/www.rhdaustralia.org.au-sites-default-files-guideline-0.pdf.Google Scholar
Haji Muhammad Ismail, HI, Hoong Phak, N, Thomas, T. Paediatric Protocols for Malaysian Hospitals, 4 th edn. Malaysian Paediatric Association, 2019. https://mpaeds.my/wp-content/uploads/2019/09/Paediatric_Protocols_4th_Edition_(MPA Version)_2nd_Print_Aug_2019.pdf.Google Scholar
Bowen, A, Currie, B, Katzenellenbogen, J, et al. The 2020 Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease, 3 rd edn. 2020. https://www.rhdaustralia.org.au/system/files/fileuploads/arf_rhd_guidelines_3rd_edition_web_updated.pdf.Google Scholar
Omar, A. Pattern of acute rheumatic fever in a local teaching hospital. Med J Malaysia 1995; 50: 125–130.Google Scholar
Seckeler, MD, Hoke, TR. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 2011; 3: 67–84. doi: 10.2147/CLEP.S12977 CrossRefGoogle ScholarPubMed
Zühlke, L, Engel, ME, Karthikeyan, G, et al. Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study). Eur Heart J 2015; 36: 1115–1122. doi: 10.1093/eurheartj/ehu449 CrossRefGoogle Scholar
Cannon, J, Roberts, K, Milne, C, Carapetis, JR. Rheumatic heart disease severity, progression and outcomes: a multi-state model. J Am Heart Assoc 2017; 6. doi: 10.1161/JAHA.116.003498 CrossRefGoogle Scholar
Nascimento, BR, Beaton, AZ. Rheumatic heart disease and socioeconomic development. Lancet Glob Health 2019; 7: e1297–e1299. doi: 10.1016/S2214-109X(19)30369-9 CrossRefGoogle ScholarPubMed
Carapetis, JR, Beaton, A, Cunningham, MW, et al. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Prim 2016; 2. doi: 10.1038/nrdp.2015.84 CrossRefGoogle Scholar
Lue, HC, Wu, MH, Wang, JK, Wu, FF, Wu, YN. Long-term outcome of patients with rheumatic fever receiving Benzathine penicillin G prophylaxis every three weeks versus every four weeks. J Pediatr 1994; 125: 812–816. doi: 10.1016/S0022-3476(06)80188-5 CrossRefGoogle ScholarPubMed
Spinetto, H, Lennon, D, Horsburgh, M. Rheumatic fever recurrence prevention: a nurse-led programme of 28-day penicillin in an area of high endemnicity. J Paediatr Child Health 2011; 47: 228–234. doi: 10.1111/j.1440-1754.2010.01942.x CrossRefGoogle Scholar
Cilliers, A, Adler, AJ, Saloojee, H. Anti-inflammatory treatment for carditis in acute rheumatic fever. Cochrane Database Syst Rev 2015; 2015. doi: 10.1002/14651858.CD003176.pub3 CrossRefGoogle Scholar
Nassri Câmara, EJ, Vieira Braga, JC, Alves-Silva, LS, Câmara, GF, Da Silva Lopes, AA. Comparison of an intravenous pulse of methylprednisolone versus oral corticosteroid in severe acute rheumatic carditis: a randomized clinical trial. Cardiol Young 2002; 12: 119–124. doi: 10.1017/S1047951102000264 CrossRefGoogle Scholar
Torres, RPA, Torres, RFA, Torres, RA, Torres, RSLA. Pulse therapy combined with oral corticosteroids in the management of severe rheumatic carditis and rebound. Cardiol Young 2018; 28: 309–314. doi: 10.1017/S1047951117002062 CrossRefGoogle ScholarPubMed
Lennon, D, Kerdemelidis, M, Arroll, B. Meta-analysis of trials of streptococcal throat treatment programs to prevent rheumatic fever. Pediatr Res 2009; 28: 259–264. doi: 10.1097/INF.0b013e3181a8e12a Google ScholarPubMed