Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease

Epidemiology and Clinical Considerations

Liesl J. Zühlke, Andrea Beaton, Mark Emmanuel Engel, Christopher T. Hugo-Hamman, Ganesan Karthikeyan, Judith M. Katzenellenbogen, Ntobeko Ntusi, Anna P. Ralph, Anita Saxena, Pierre R. Smeesters, David Watkins, Peter Zilla, Jonathan Carapetis

    Research output: Contribution to journalReview articleResearchpeer-review

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    Abstract

    Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF. It is a requirement to identify high-risk individuals with RHD such as those with heart failure, pregnant women, and those with severe disease and multiple valve involvement. As penicillin is the mainstay of primary and secondary prevention, further research into penicillin supply chains, alternate preparations and modes of delivery is required.

    Original languageEnglish
    Article number15
    Pages (from-to)1-23
    Number of pages23
    JournalCurrent Treatment Options in Cardiovascular Medicine
    Volume19
    Issue number2
    DOIs
    Publication statusPublished - Feb 2017

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    Rheumatic Heart Disease
    Rheumatic Fever
    Streptococcus
    Epidemiology
    Penicillins
    Penicillin G Benzathine
    Decision Support Techniques
    Pharyngitis
    Long-Term Care
    Primary Prevention
    Secondary Prevention
    Pregnant Women
    Primary Health Care
    Differential Diagnosis
    Heart Failure
    Research
    Population

    Cite this

    Zühlke, L. J., Beaton, A., Engel, M. E., Hugo-Hamman, C. T., Karthikeyan, G., Katzenellenbogen, J. M., ... Carapetis, J. (2017). Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations. Current Treatment Options in Cardiovascular Medicine, 19(2), 1-23. [15]. https://doi.org/10.1007/s11936-017-0513-y
    Zühlke, Liesl J. ; Beaton, Andrea ; Engel, Mark Emmanuel ; Hugo-Hamman, Christopher T. ; Karthikeyan, Ganesan ; Katzenellenbogen, Judith M. ; Ntusi, Ntobeko ; Ralph, Anna P. ; Saxena, Anita ; Smeesters, Pierre R. ; Watkins, David ; Zilla, Peter ; Carapetis, Jonathan. / Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease : Epidemiology and Clinical Considerations. In: Current Treatment Options in Cardiovascular Medicine. 2017 ; Vol. 19, No. 2. pp. 1-23.
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    title = "Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations",
    abstract = "Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF. It is a requirement to identify high-risk individuals with RHD such as those with heart failure, pregnant women, and those with severe disease and multiple valve involvement. As penicillin is the mainstay of primary and secondary prevention, further research into penicillin supply chains, alternate preparations and modes of delivery is required.",
    keywords = "Acute rheumatic fever, Benzathine penicillin, Echocardiography, Global burden of disease, Group A streptococcus, Pathogenesis",
    author = "Z{\"u}hlke, {Liesl J.} and Andrea Beaton and Engel, {Mark Emmanuel} and Hugo-Hamman, {Christopher T.} and Ganesan Karthikeyan and Katzenellenbogen, {Judith M.} and Ntobeko Ntusi and Ralph, {Anna P.} and Anita Saxena and Smeesters, {Pierre R.} and David Watkins and Peter Zilla and Jonathan Carapetis",
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    Zühlke, LJ, Beaton, A, Engel, ME, Hugo-Hamman, CT, Karthikeyan, G, Katzenellenbogen, JM, Ntusi, N, Ralph, AP, Saxena, A, Smeesters, PR, Watkins, D, Zilla, P & Carapetis, J 2017, 'Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations', Current Treatment Options in Cardiovascular Medicine, vol. 19, no. 2, 15, pp. 1-23. https://doi.org/10.1007/s11936-017-0513-y

    Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease : Epidemiology and Clinical Considerations. / Zühlke, Liesl J.; Beaton, Andrea; Engel, Mark Emmanuel; Hugo-Hamman, Christopher T.; Karthikeyan, Ganesan; Katzenellenbogen, Judith M.; Ntusi, Ntobeko; Ralph, Anna P.; Saxena, Anita; Smeesters, Pierre R.; Watkins, David; Zilla, Peter; Carapetis, Jonathan.

    In: Current Treatment Options in Cardiovascular Medicine, Vol. 19, No. 2, 15, 02.2017, p. 1-23.

    Research output: Contribution to journalReview articleResearchpeer-review

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    AU - Engel, Mark Emmanuel

    AU - Hugo-Hamman, Christopher T.

    AU - Karthikeyan, Ganesan

    AU - Katzenellenbogen, Judith M.

    AU - Ntusi, Ntobeko

    AU - Ralph, Anna P.

    AU - Saxena, Anita

    AU - Smeesters, Pierre R.

    AU - Watkins, David

    AU - Zilla, Peter

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    AB - Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF. It is a requirement to identify high-risk individuals with RHD such as those with heart failure, pregnant women, and those with severe disease and multiple valve involvement. As penicillin is the mainstay of primary and secondary prevention, further research into penicillin supply chains, alternate preparations and modes of delivery is required.

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