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Sydenham Chorea and PANDAS in South Africa: Review of Evidence and Recommendations for Management in Resource-Poor Countries.
[acute rheumatic fever]
In
South
Africa
,
and
worldwide
,
rheumatic
fever
represents
a
public
health
problem
.
Improved
diagnosis
and
management
of
Sydenham
chorea
,
a
major
manifestation
of
acute
rheumatic
fever
is
key
to
prevention
of
rheumatic
heart
disease
.
This
article
reviews
Sydenham
chorea
from
its
original
description
to
current
opinions
.
Recommendations
are
founded
on
expert
opinion
as
class
1
data
is
lacking
.
This
South
African
perspective
is
relevant
to
resource-
poor
settings
globally
insofar
as
it
provides
diagnosis
and
management
recommendations
for
primary
-
and
secondary
-level
healthcare
professionals
who
care
for
patients
in
such
environments
.
Four
basic
tenets
of
care
are
recommended
,
namely
,
elimination
of
the
streptococcal
infection
,
symptomatic
treatment
,
immunological
treatment
,
and
nonpharmacologic
interventions
.
A
user-friendly
outcome
measurement
tool
,
viable
for
use
in
low
-resource
settings
is
presented
.
Introduction
of
this
tool
may
lead
to
increased
awareness
of
the
neuropsychiatric
manifestations
of
poststreptococcal
movement
disorders
in
Africa
,
where
reports
are
limited
.
Diseases
Validation
Diseases presenting
"secondary-level healthcare professionals"
symptom
acute rheumatic fever
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