title: Population-based study of incidence and clinical characteristics of rheumatic fever in Abruzzo, central Italy, 2000-2009.
abstract: OBJECTIVE
  To investigate the incidence and describe the characteristics of acute rheumatic fever (ARF) in the pediatric population in a community-based healthcare delivery system of the central Italy region of Abruzzo during 2000-2009.
  
  
  METHODS
  A retrospective study was conducted in Abruzzo to identify patients aged <18 years with a diagnosis of ARF between January 1, 2000, and December 31, 2009. Each patient's age, sex, date of diagnosis, age at disease presentation, and fulfilled Jones criteria were recorded.
  
  
  RESULTS
  A total of 88 patients meeting the Jones criteria for the diagnosis of ARF were identified, with arthritis in 59.1% of the patients, carditis in 48.9%, erythema marginatum in 11.4%, 5.7% with chorea, and 4.6% with subcutaneous nodules. Residual chronic rheumatic heart disease was present in 44.3% of the children. Age at diagnosis ranged from 2.5 to 17 years (average, 8.7 ± 4.0 years). Twelve children (13.6%) were under age 5 years. The overall incidence rate of ARF was 4.1/100 000. The lowest incidence rate was documented in the year 2000 (2.26/100 000), and the highest in 2006 (5.58/100 000).
  
  
  CONCLUSIONS
  Our data indicate that ARF has not disappeared in industrialized countries and still causes significant residual rheumatic heart disease. Pediatricians should routinely consider the diagnoses of streptococcal pharyngitis and ARF to reduce long-term morbidity and mortality.
authors: Department of Pediatrics, University of Chieti, Chieti, Italy. luciana.breda@yahoo.it
authors: Luciana
authors: L
authors: Breda
authors: Valentina
authors: V
authors: Marzetti
authors: Stefania
authors: S
authors: Gaspari
authors: Marianna
authors: M
authors: Del Torto
authors: Francesco
authors: F
authors: Chiarelli
authors: Emma
authors: E
authors: Altobelli
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D000900:Anti-Bacterial Agents; D018501:Antirheumatic Agents