n South African Medical Journal - The four pillars of rheumatic heart disease control : editorial




The National Department of Health has promulgated the first week of August as National Rheumatic Fever Week ever since rheumatic fever was made a notifiable condition in 1989. The results of the Heart of Soweto Study, however, show that very little progress has been made in reducing the burden of rheumatic heart disease over the past 20 years. This prospective study of 4 005 patients with heart disease who presented at Chris Hani Baragwanath Hospital during 2006/07 showed that 960 (24%) had valvular heart disease. The incidence of new cases of rheumatic heart disease for those aged <14 years in Soweto was 23.5 cases/100 000 per annum, which puts this urban community among the high-incidence communities of the world. It is not surprising that this preventable condition remains common, because of inadequate implementation of the guideline for the prevention of rheumatic fever in South Africa. A recent study showed that very few paediatricians were aware that rheumatic fever is a notifiable condition, and that the national notification system administered by the Department of Health was dysfunctional.


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