Kayemba Kay's Kabangu S, Dupuis E
Service de pédiatrie, centre hospitalier Louis-Domergue, Trinité, Martinique, France.
Pediatrie. 1993;48(11):823-7.
The authors report 34 cases of acute rheumatic fever observed in children in the North-Atlantic region of the Martinique island during a 5 years period (1987-1991). The majority of the patients belong to areas with poor socio-economic conditions. Clinical manifestations are mainly polyarthritis, monoarthritis, and abdominal pain, associated with accelerated erythrocyte sedimentation rate and high antistreptolysin O titer. Carditis remains the most important complication, 14 out of 34 children being concerned. The prognosis is favorable in most cases, but four children have mitral valve insufficiency and two other have moderate aortic valve insufficiency as sequelae. Although there is a decline in the incidence of the disease in comparison to previous years, the same endemic area is found in this study. Explanations of this phenomenon and recommendations for a new eradication campaign are discussed.