Hung-Chi Lue|Chiung-Lin Chen|Hong-Jian Wei|Masahiko Okuni|Luis M. Mabilangan|Duangsuda Dharmasakti|A Hanafiah
The Natural History of Rheumatic Fever and Rheumatic Heart Disease in the Orient
National Taiwan University|National Taiwan University|National Taiwan University|Nihon University|University of the Philippines System|Children's Hospital|University of Indonesia
studies published past 10 years suggest group streptococcal infections frequent orient lead high incidence rheumatic fever rf rheumatic heart disease rhd present study streptococcal infections found prevalent japan taiwan whereas rf rhd common severe philippines thailand indonesia particularly among socioeconomically less privileged populations pattern childhood rf varied carditis common manifestation occurring 57 94 patients polyarthritis generally atypical less common tropics chorea minor erythema marginatum much common japan less common taiwan rare tropics rf recurrences quite common led development new carditis deterioration persistence preexisting heart disease 5 year mortality rates differed greatly ranging zero 42 disappearance heart murmur 165 375 patients apparent recovery related adherence chemoprophylaxis major risk factors adversely affecting survival severity carditis inadequacy medical service noncompliance chemoprophylaxis rf recurrence poor socioeconomic status high prevalence group streptococci concluded uniform orientaltype natural history rf rhd natural history varies greatly among countries true parts world