title: Evaluation of the policy of secondary prevention against rheumatic fever among Egyptian children.
abstract: OBJECTIVE
  We evaluated the effectiveness of long acting penicillin (LAP) as a 2-weekly regimen in winter and a 3-weekly regimen in summer for prevention of streptococcal colonization and also studied the common complaints of patients during the period of compliance for LAP administration. We also attempted to determine the incidence of relapses or recurrence of rheumatic fever (RF) after the onset of first episode of RF.
  
  
  METHODS
  210 rheumatic patients with good compliance to LAP (for at least one year) were included in the study. Demographic, clinical information, patients' complaints and echocardiographic data of rheumatic patients were collected both retrospectively and prospectively. Anti-streptolysin O titre (ASOT) and throat swab culture were done at the end of the study (on Day 14 in the 2-weekly regimen and on Day 21 in the 3-weekly regimen).
  
  
  RESULTS
  The age of onset of rheumatic fever was mostly between 5 and 15 years and the youngest patient was 2 years old. Subclinical carditis (SCC) was present in 79 (37%) of all the patients in the study population. Only 7 patients (3.3%) had a relapse within 2 years of the acute episode of RF. At the end of the study, ASOT was found to be high only in 11 patients (5.2%) and throat swab cultures were found negative in all patients
  
  
  CONCLUSIONS
  LAP regimen is fairly effective in eradicating streptococcal colonization. The incidence of relapse of RF within 2 years of the acute episode of RF is relatively low.
authors: Prof. of Pediatrics, Consultant of Endocrinology, Pediatrics Department, National Research Centre, Cairo, Egypt. Electronic address: S_eldayem@yahoo.com.
authors: Soha M
authors: SM
authors: Abd El Dayem
authors: Pediatrics Department, Cairo University, Cairo, Egypt.
authors: Hala
authors: H
authors: Hamza
authors: Clinical Pathology Department, Cairo University, Cairo, Egypt.
authors: Sohair
authors: S
authors: Helal
authors: Pediatrics Department, National Research Centre, Cairo, Egypt.
authors: Azza
authors: A
authors: Mohamed
authors: Pediatrics Department, National Research Centre, Cairo, Egypt.
authors: Heba
authors: H
authors: Hassan
keywords: Prevention; Rheumatic patients; Streptococcal
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