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.. Objectives: To investigate the role of socio-economic factors for Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) in Pakistan. Methodology: Study Design: Descriptive cross-sectional. Setting: OPD of Pediatric Cardiology Department, CPE Institute of Cardiology, Multan. Period: July 2014 to December 2014. Convenience Sampling was done. Sample size of 130 cases with ages between 5 to 12 years were selected for the study. Results: Overcrowding was noticed in 61% and 85% in urban and rural areas, respectively. In rural areas, most parents were illiterate; similar status was seen in urban areas (64.4%; 67.1% respectively). 60% and 55 % patients have habit of hand washing in rural and urban patients respectively. Toilet facility is available to 60% and 55.6% in rural and urban patients respectively. Economic status of the family is even worse. Average income per family was only Rs.3800 per month. Conclusion: There is a high prevalence of Rheumatic heart disease (RHD) and acute rheumatic fever (ARF) in Pakistan. Overcrowding, poor hygienic conditions, low socio-economic status, illiteracy are major risk factors for ARF and RHD in Pakistan. In order to address this alarming situation, platforms like Pakistan Pediatric Cardiac Society and Pakistan Pediatric Association need to be mobilized.

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RHEUMATIC HEART DISEASE (RHD); SOCIO-ECONOMIC AND ENVIRONMENTAL RISK FACTORS FOR ACUTE RHEUMATIC FEVER (ARF) AND RHEUMATIC HEART DISEASE (RHD) PATIENTS IN PAKISTAN