Preliminary Study on Acute Rheumatic Fever at High and Low Altitudes of Asir Region

OBJECTIVE: The objective was to study the profile of acute rheumatic fever (ARF) at high and low altitudes (hot and temperate areas respectively) with particular attention to the influence of these differences on the frequency or severity of carditis. METHODOLOGY: Thirty eight children with initial attack of ARF, diagnosed between November 1987 and July 1995, were studied. RESULT: Twenty seven were living at altitude, temperate climate (group-1) while 11 were living at low altitudes of Tihama, hot climate (group-2). Twenty two were males and 16 were females. The mean age was 9.7 years. Arthritis was the commonest feature (86.8%) and carditis (68.4%) came second. Mitral regurgitation occurred in 96.2% of those with carditis, aortic regurgitation occurred in 19.2% and tricuspid regurgitation in 7.7%. Mitral stenosis and aortic stenosis were not encountered. A comparison between group-1 and group-2 showed the frequency of carditis to be 66.7% and 72.7% respectively and the frequency of severe carditis in those affected to be 27.8% and 25% respectively. Chorea, erythema marginatum and subcutaneous nodules were uncommon. CONCLUSION: The study indicates that altitude and climate may not affect the frequency nor severity of carditis.