The Natural History of Rheumatic Fever and Rheumatic Heart Disease in the Orient
スポンサーリンク
概要
- 論文の詳細を見る
Studies published in the past 10 years suggest that group A streptococcal infections are frequent in the Orient and lead to a high incidence of rheumatic fever (RF) and rheumatic heart disease (RHD). In the present study, streptococcal infections were found to be more prevalent in Japan and Taiwan, whereas RF and RHD were more common and severe in the Philippines, Thailand, and Indonesia, particularly among the socioeconomically less privileged populations. The pattern of childhood RF varied: Carditis was the most common manifestation, occurring in 57% to 94% of the patients; polyarthritis was generally atypical and less common in the tropics; chorea minor and erythema marginatum were much more common in Japan, less common in Taiwan and rare in the tropics. RF recurrences were quite common and led to the development of new carditis, and deterioration or persistence of the preexisting heart disease. The 5 year mortality rates differed greatly, ranging from zero to 42%.There was disappearance of the heart murmur in 16.5% to 37.5% of patients. Such apparent recovery was related to adherence to chemoprophylaxis. The major risk factors adversely affecting survival were the severity of carditis, inadequacy of medical service, noncompliance to chemoprophylaxis, RF recurrence, poor socioeconomic status, and high prevalence of group A streptococci. It is concluded that there is no uniform "Orientaltype" of natural history of RF and RHD. The natural history varies greatly among countries as is true in other parts of the world.
- International Heart Journal刊行会の論文
著者
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Okuni Masahiko
Department Of Pediatrics And Pathology Nihon University School Of Medicine
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CHEN CHIUNG-LIN
Department of Pediatrics and Cardiopulmonary Function Laboratory, National Taiwan University
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WEI HUOYAO
Department of Pediatrics and Cardiopulmonary Function Laboratory, National Taiwan University
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Lue Hung-chi
Department Of Pediatrics
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MABILANGAN Luis
Department of Pediatrics, University of the Philippines College of Medicine
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DHARMASAKTI Duangsuda
Childrens Hospital
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HANAFIAH A.
Department of Cardiology, University of Indonesia Faculty of Medicine
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OKUNI Masahiko
Department of Pediatrics, Nihon University School of Medicine
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DHARMASAKTI Duangsuda
Children's Hospital
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