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 "heart disease" symptom

22q11.2 deletion syndrome

achondroplasia

acute rheumatic fever

adrenal incidentaloma

child syndrome

classical phenylketonuria

cohen syndrome

congenital diaphragmatic hernia

dentinogenesis imperfecta

esophageal adenocarcinoma

fabry disease

familial mediterranean fever

heparin-induced thrombocytopenia

hirschsprung disease

holt-oram syndrome

homocystinuria without methylmalonic aciduria

kabuki syndrome

monosomy 21

omenn syndrome

phenylketonuria

sneddon syndrome

systemic capillary leak syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

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