n CME : Your SA Journal of CPD - Rheumatic heart disease and the ASAP programme : fresh insights into an old disease




Acute rheumatic fever (ARF) is the immune-mediated sequel of an innocuous Group A streptococcal throat infection and occurs in 0.3 - 3.0% of children between the ages of 3 and 15 who have untreated sore throat. Although ARF involves skin, subcutaneous tissue, brain and joints, only the devastating effects on the heart valves are permanent and associated with a number of serious sequelae. This is thought to affect about 60% of new cases of rheumatic fever per year. Current estimates suggest that 62 - 78 million individuals worldwide may have rheumatic heart disease (RHD), which could potentially result in 1.4 million deaths per year from the disease and its complications. These individuals are predominantly children, adolescents and young adults who live in poor and under-resourced areas of the world.


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