A dramatic decline in university hospital admissions of acute rheumatic fever in the eastern region of Saudi Arabia

Acute rheumatic fever (ARF) and its sequel, chronic valvular heart disease are the most important causes for cardiovascular morbidity and mortality worldwide and mainly in developing countries. However, the incidence of ARF has declined in developed countries during the second half of 20th century. The case files of all patients admitted as new cases of ARF over ∼11 years and 8 months, both in pediatric and medical departments of a university hospital located in the eastern region of Saudi Arabia were reviewed. The demographic and clinical data and the frequency of the new cases were compared with the data that have been published by us 10 years ago from the same hospital during a similar period of time (11 years and 8 months). In the current study there was a significant decline in the frequency of admission of cases of ARF as compared to our previous study during a similar period of time, with a frequency rate of 12 cases per 100.000 hospitalizations versus 45 cases per 100.000 hospitalizations, respectively, P < 0.001. Dyspnea and chest pain as clinical features of acute rheumatic carditis (ARC) were less frequent in the current study as compared to the previous study (35% versus 44%, P = 0.02 and 10% versus 28.6%, P = 0.031). The subgroup analysis revealed also a decreased frequency of the clinical features of ARC in pediatric age group in the current study as compared to our previous study. There is a significant decline in the frequency of new hospital admissions due to ARF. This decline was associated with similar decline in the frequency of the manifestations of ARC especially in pediatric age group (1–12 years).