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Study: Rheumatic Fever Widespread in Developing World, Often Undetected 


Experts say that rheumatic fever, an inflammation that can affect the heart and become fatal, is widespread throughout the developing world, but often undetected by doctors. They say more people could be diagnosed using a test called an echocardiogram that takes images of the heart. VOA's Jessica Berman reports.

Rheumatic fever has been called a disease of poverty. The inflammatory heart condition is caused by the same bacterial that caused the strep throat, a streptococcus bacterial infection, that goes untreated. It has become rare in the developed world because of the widespread use of antibiotics.

But it is still prevalent in the developing world, where health officials estimate there are 16 million people with the disease. More than a quarter of a million die each year from rheumatic heart disease, caused by rheumatic fever. RHD frequently involves damage to heart valves and irregular heart rhythms. Rheumatic fever mostly strikes children and is easily treated.

Because many cases of rheumatic fever do not produce symptoms, many doctors fail to diagnose it by examination alone.

To find out if there is a better way to diagnose the disease, French and Cambodian researchers studied the use of a heart imaging technique, called echocardiography, which takes pictures of the heart.

In a study of 3,600 children in Cambodia, echocardiography detected 80 cases of rheumatic fever compared to eight cases detected by doctors' examinations alone. Of 2,100 children in Mozambique, echocardiography detected nearly 70 cases of the disease compared to five cases picked up by doctors.

The results of the study have been published in the New England Journal of Medicine.

Eloi Marijon, a doctor at a hospital in Paris and the study's main investigator, says the study found that ten times more people are infected with rheumatic fever than official estimates show. "So we found that nine children out of ten were not detected by clinical examination," he said.

Marijon says an echocardiogram uses ultrasound to bounce sound waves off the heart and produce a picture. He says the machine costs around $10,000.

In resource-poor countries, he says it might be hard to find that kind of money. But Maijon says the machine would make an enormous difference. "With portable ultrasound equipment we can check a lot of children. So, I think it's not too expensive," he said.

Observers say the results of the study require urgent attention by the international community. Until a vaccine against rheumatic fever is developed, they say a practical and affordable way should be found to get echocardiograph machines to countries where they are most needed.

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