It is not known if the latter issue is a result of health-seeking behavior (people with ARF who choose not to seek health care), or due to inadequate diagnosis of ARF by health staff. This relates both to the lack of infrastructure for disease surveillance in those settings, but also to a paucity of ARF cases that are presented for clinical care. Incidence rates of ARF are poorly documented in most low- and middle-income countries, including in populations with a high prevalence of RHD, where it is presumed that a high incidence of ARF also occurs. The global burden of ARF and RHD is significant, and is predominantly found in populations living in low-resource settings ( Carapetis, Steer, Mulholland, & Weber, 2005). Finally this chapter will also highlight prevention strategies for ARF and RHD and will discuss current vaccination efforts against S. This chapter will briefly cover the epidemiology and pathophysiology of ARF and RHD, and will also outline the clinical manifestations, diagnostic considerations, and recommended treatment and management options for both conditions. pyogenes pharyngitis infections, ARF can recur and cause cumulative damage to the heart valves ( Martin, et al., 2015). These symptoms usually require patients to be hospitalized for two to three weeks, during which time the outward symptoms resolve, but the resultant cardiac damage may persist. Symptoms of ARF can include polyarthritis, carditis, chorea, the appearance of subcutaneous nodules, and erythema marginatum or a rash associated with ARF ( Gewitz, et al., 2015 Martin, et al., 2015). The clinical manifestations and symptoms of ARF can be severe and are described in the Revised Jones Criteria ( Gewitz, et al., 2015). pyogenes infection ( Gewitz, et al., 2015). The development of ARF occurs approximately two weeks after S. pyogenes infections may not be treated, which allows for the development of harmful post-infectious sequelae ( Carapetis, 2007). Currently, these diseases mainly affect those in low- and middle-income nations, as well as in indigenous populations in wealthy nations where initial S. pyogenes infections have caused these diseases to become comparatively rare in wealthy areas ( Carapetis, 2007). While ARF and RHD were once common across all populations, improved living conditions and widespread treatment of superficial S. It is RHD that remains a significant worldwide cause of morbidity and mortality, particularly in resource-poor settings. Rheumatic heart disease (RHD) refers to the long-term cardiac damage caused by either a single severe episode or multiple recurrent episodes of ARF. Acute rheumatic fever (ARF) results from the body’s autoimmune response to a throat infection caused by Streptococcus pyogenes, also known as the group A Streptococcus bacteria.
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