الفهرس 
INTRODUCTION AND RATIONALEOnly 14 pages are availabe for public view
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Abstract
Acute rheumatic fever (ARF) is a delayed sequela of streptococcal pharyngitis during childhood that involves many body systems. Rheumatic heart disease (RHD) is a serious health problem that leads to long-term morbidity and mortality. Effective early intervention can prevent premature mortality from RHD, which includes prevention, early diagnosis and treatment of ARF. Intramuscular Long-acting penicillin (LAP) is the most effective antimicrobial agent in secondary prevention of RF.
In Egypt, the prevalence of RHD among basic education students in Alexandria was 6.2/1000 students, with more than half of them suffering from moderately severe valvular lesions. Low socioeconomic status, chronic tonsillitis, positive family history of acute rheumatic fever/RHD and paternal consanguinity were associated with the development of RHD.
This study aims to assess the non-indicated long-term use of long-acting penicillin. Our objectives were to estimate the prevalence of basic education students who receive LAP on regular basis as a prophylaxis against ARF, and to assess the criteria on which they were prescribed the treatment.
We conducted a descriptive survey that included 2180 students in Ismailia government aged between 6 – 15 years. All the students answered the questionnaire about their sociodemographic data and presence of RF symptoms as described in the Johns criteria; arthritis and arthralgia (joint symptoms), chest pain, palpitations or dyspnea (carditis), abnormal involuntary movements (chorea), skin lesions (erythema marginatum or subcutaneous nodules), fever and recurrent tonsilitis. Those who reported LAP administration had their parents contacted and further asked about the documented investigations results such as throat swab, ASOT, CRP, ESR, TLC, ECG, and the treatment of their child; including the frequency and duration of LAP and side effects.