الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Rheumatic fever is an autoimmune response to bacterial infection with (GAS). It is a systemic disease affecting the peri-arteriolar connective tissue and can occur after an untreated GAS pharyngeal infection. It can affect all the layers of the heart and hence called pancarditis.
Although, the incidence of rheumatic fever declines in industrialized countries, it is still a major health problem in developing countries. In Egypt the condition improved after the use of antibiotics. Although the incidence of the disease decreased in developed countries, there was resurgence of rheumatic fever in the USA in mid 1980s.
Low public awareness, lack of appropriate and early diagnosis of streptococcal sore throat, low socioeconomic status, poor transport facilities, overburdened clinics, and overcrowding increase the risk of RF and RHD.
Rheumatic fever and rheumatic heart disease affect children and young adults which is the most productive age group in any society, this has negative impact on the patient and on the entire community. It has negative psychological, financial, and social effects on the patients.
These effects reduce the ability of the patient to enjoy life and to work effectively, which in turn together with costs of treatment and disease prevention affect the community.
So we should improve public awareness, health care facilities, and our socioeconomic standard to help in decreasing the disease incidence.
Our study was a cross-sectional study carried on 200 children who were diagnosed to have RF/ RHD and attending the cardiology clinic at Alexandria University Children Hospital for assessment, follow up and management.
The aim of our work was to assess the demographic state of children with Rheumatic fever/Rheumatic heart disease (RHD).
All patients were subjected to a designed interview questionnaire involving:
• Personal information
• Heart disease related data
• Family medical history
• Housing and socioeconomic data
• Environmental condition
• Demographic condition
We found that:
• The provider of information of the studied cases was the patient himself or one of his family mostly was his mother (51%).
• 51.5% of the cases had chronic rheumatic heart disease, while 48.5% of the cases had not chronic rheumatic heart disease.
• Cardiac function was normal in 82% of cases while 6% had decompensated cardiac function, no complications were found in 84% of cases, 7.5% of the cases had pulmonary hypertension, 6.5% had arrhythmia, 2% had endocarditis, and 12% of cases had undergone valve surgeries.
• Mitral regurge was found in 75% of cases while aortic regurge was found in 54.5% of cases.
• 51.5% of patients have no restrictions to daily activities and excersises.
• In our study, male patients (55%) are more than female patients (45%).
• Most of cases were living in Alexandria governorate (57.5%), while the rest of patients were living between EL-Beheira governorate and kafr- Elsheikh governorate and are receiving their medical services in Alexandria university hospital.
• Most of cases were learning in governmental schools (54.5%), which are more crowded than non-governmental schools.
• 67% of the cases were not working, and 84.8%of the working patients were part timers.
• Most of the cases have family monthly income less than 1000 LE (56%).
• 61% of the patients had illiterate mothers while 46% of the patients had illiterate father.
• 83% of the patients had unemployed mothers, while only 4% had unemployed fathers.
• We found that 92%of the patients had feeding water, 60.5% had sanitary sewage disposal system, and 65% had good ventilation system.
• 64% of the patients were living in rural environment with low socioeconomic standards and low public awareness, while 29% were living in urban environment.
• 90% of cases were living away from harmful factories,56% of cases were living in slums.
• Most of cases comes from villages 46.5% and suburbs 28%.
• 97% of the patients had regular visit to the health unit every two weeks.
• 82% of the patients had excellent regularity in receiving long acting penicillin.