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Rheumatic heart disease (RHD) remains a leading cause of morbidity and mortality among young adults in the developing world, accounting for at least 345,000 deaths annually [1, 2]. RHD is the long term consequence of rheumatic fever, an autoimmune response to Group A streptococcal pharyngitis [3]. Without prophylaxis, patients with RHD are at risk of recurrent attacks of rheumatic fever resulting in ongoing inflammation and fibrosis with consequent valvular damage [4, 5]. Although its incidence is decreasing in industrialized countries, RHD remains a major challenge in the rest of the world. The highest prevalence is in sub-Saharan Africa with a rate of 5.7 per 1000, compared to 1.8 per 1000 in North Africa, and 0.3 per 1000 in economically advanced countries [6]. In Ethiopia, RHD is the number one cardiac problem in children with a prevalence rate of 4.6–7.1 per 1000 [7, 8]. Particularly frustrating has been the fact that RHD are theoretically preventable but still remains a problem in developing countries. Reason most advanced is that these countries cannot afford the economic and social cost involved [9].

arc journal of cardiology

Normal Value of Antistreptolysin O Titer in Rheumatoid Heart Disease who Are on Secondary Prophylaxis and in Apparently Healthy Children at Debre Berhan Referral Hospital, Ethiopia