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A cost-effective strategy for primary prevention of acute rheumatic fever and rheumatic heart disease in children with pharyngitis.
[acute rheumatic fever]
Primary
prevention
of
acute
rheumatic
fever
(
ARF
)
and
rheumatic
heart
disease
(
RHD
)
in
children
depends
on
prompt
and
effective
diagnosis
and
treatment
of
pharyngitis
at
the
primary
level
of
care
.
Cost-effectiveness
modeling
shows
that
the
most
cost-effective
strategy
for
primary
prevention
in
South
Africa
(
SA
)
is
to
use
a
simple
symptomatic
clinical
decision
rule
(
CDR
)
to
diagnose
pharyngitis
in
children
presenting
at
the
primary
level
of
care
and
then
to
treat
them
with
a
single
dose
of
intramuscular
penicillin
.
Treat
All
and
CDR
2
+
strategies
are
affordable
and
simple
and
miss
few
cases
of
streptococcal
pharyngitis
at
the
primary
level
of
care
.
The
CDR
2
+
strategy
is
the
most
cost-effective
for
primary
prevention
of
ARF
and
RHD
in
urban
SA
and
should
complement
primordial
and
secondary
prevention
efforts
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated