Title |
Acute rheumatic fever
|
---|---|
Published in |
The Lancet, July 2005
|
DOI | 10.1016/s0140-6736(05)66874-2 |
Pubmed ID | |
Authors |
Jonathan R Carapetis, Malcolm McDonald, Nigel J Wilson |
Abstract |
Acute rheumatic fever (ARF) and its chronic sequela, rheumatic heart disease (RHD), have become rare in most affluent populations, but remain unchecked in developing countries and in some poor, mainly indigenous populations in wealthy countries. More than a century of research, mainly in North America and Europe, has improved our understanding of ARF and RHD. However, whether traditional views need to be updated in view of the epidemiological shift of the past 50 years is still to be established, and improved data from developing countries are needed. Doctors who work in populations with a high incidence of ARF are adapting existing diagnostic guidelines to increase their sensitivity. Group A streptococcal vaccines are still years away from being available and, even if the obstacles of serotype coverage and safety can be overcome, their cost could make them inaccessible to the populations that need them most. New approaches to primary prevention are needed given the limitations of primary prophylaxis as a population-based strategy. The most effective approach for control of ARF and RHD is secondary prophylaxis, which is best delivered as part of a coordinated control programme. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | 14% |
Nigeria | 1 | 7% |
Malaysia | 1 | 7% |
Cabo Verde | 1 | 7% |
United States | 1 | 7% |
Venezuela, Bolivarian Republic of | 1 | 7% |
Ghana | 1 | 7% |
Mexico | 1 | 7% |
Unknown | 5 | 36% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 10 | 71% |
Practitioners (doctors, other healthcare professionals) | 4 | 29% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Brazil | 6 | 2% |
United States | 4 | 1% |
Switzerland | 1 | <1% |
Turkey | 1 | <1% |
Colombia | 1 | <1% |
Chile | 1 | <1% |
Australia | 1 | <1% |
France | 1 | <1% |
Bangladesh | 1 | <1% |
Other | 4 | 1% |
Unknown | 368 | 95% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 57 | 15% |
Student > Master | 45 | 12% |
Researcher | 37 | 10% |
Student > Ph. D. Student | 35 | 9% |
Student > Postgraduate | 30 | 8% |
Other | 92 | 24% |
Unknown | 93 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 201 | 52% |
Agricultural and Biological Sciences | 28 | 7% |
Immunology and Microbiology | 11 | 3% |
Biochemistry, Genetics and Molecular Biology | 10 | 3% |
Nursing and Health Professions | 6 | 2% |
Other | 41 | 11% |
Unknown | 92 | 24% |