Coulehan J, Grant S, Reisinger K, Killian P, Rogers K D, Kaltenbach C
Public Health Rep. 1980 Jan-Feb;95(1):62-8.
The occurrence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) among Navajos was ascertained for the period from 1962 through 1977 by means of hospital discharge diagnoses and patients' charts. The annualized attack rate for ARF was 12.4 per 100,000 population, with no clear evidence of an overall secular trend. The proportion of recurrences (19.6 percent) and clinical features were similar to those reported elsewhere, but no seasonal variation in attack rates was noted. Between 1962-71 and 1972-77, the age of RHD patients increased, suggesting few newly diagnosed cases and the aging of known patients. A streptococcal disease control program was instituted in many Navajo elementary schools before 1975. In the program, throat cultures were performed routinely for some asymptomatic children and for all symptomatic children. During the subsequent 3 years, ARF rates declined from 13.5 to 8.2 per 100,000 in areas covered by the program, while in the noncovered areas the rates showed little change-9.5 to 10.1 per 100,000.
通过医院出院诊断和患者病历，确定了1962年至1977年期间纳瓦霍人急性风湿热（ARF）和风湿性心脏病（RHD）的发病情况。ARF的年化发病率为每10万人12.4例，没有明显的总体长期趋势证据。复发比例（19.6%）和临床特征与其他地方报告的相似，但未观察到发病率的季节性变化。在1962 - 1971年和1972 - 1977年期间，RHD患者的年龄有所增加，这表明新诊断病例较少，已知患者老龄化。1975年前，许多纳瓦霍小学实施了链球菌疾病控制计划。在该计划中，对一些无症状儿童和所有有症状儿童常规进行咽喉培养。在随后的3年里，该计划覆盖地区的ARF发病率从每10万人13.5例降至8.2例，而在未覆盖地区，发病率变化不大，从每10万人9.5例降至10.1例。
