Browsing by Author "Robertson, Kate A"

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    Notification of rheumatic fever in South Africa - evidence for underreporting by health care professionals and administrators
    (2006) Nkgudi, Boitumelo; Robertson, Kate A; Volmink, Jimmy; Mayosi, Bongani M
    Objective. To determine whether under-reporting of rheumatic fever occurs at hospital, municipal, provincial and national levels of the South African health system. Background. Information on the incidence of rheumatic fever (RF) and the prevalence of rheumatic heart disease (RHD) is required for the prevention of valvular heart disease in developing countries. In South Africa, RF was made a notifiable condition in 1989. It has recently been suggested that the reporting of RF cases may be incomplete, possibly because of underreporting by health care professionals and deficient administration of the disease notification system in South Africa. Method and results. We assessed whether underreporting of RF cases occurs by comparing the numbers of RF cases reported per year at hospital, municipal, provincial and national levels from 1990 to 2004. There was a fall in the number of RF cases reported per year at national and provincial level over the 15 years of observation. A detailed analysis of the number of RF cases reported at hospital, municipal and provincial level for a 5-year period showed that more cases were diagnosed in one hospital (serving a smaller population) than were captured at municipal and provincial level (serving a larger population), suggesting underreporting by health care professionals. There were discrepancies in the number of cases reported at municipal, provincial and national level, suggesting poor administration of the notification system. Conclusion. There appears to be underreporting of RF cases by health care professionals, and poor administration of the RF notification system. Health care professionals need to be educated about the statutory requirement to notify all RF cases in South Africa. An effective national disease notification system is required.
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    Towards a uniform plan for the control of rheumatic fever and rheumatic heart disease in Africa - the Awareness Surveillance Advocacy Prevention (ASAP) Programme
    (2006) Robertson, Kate A; Volmink, Jimmy A; Mayosi, Bongani M
    Over the last 150 years the developed world has experienced a dramatic decline in the incidence and prevalence of rheumatic fever and rheumatic heart disease (RF/RHD) through improved living conditions and the widespread use of penicillin for the treatment of streptococcal pharyngitis. Despite the proven effectiveness and availability of penicillin for both primary and secondary prevention of RF, developing countries continue to face unacceptably high rates of the disease.1 RF/RHD is the most common cardiovascular disease in children and young adults in the world, because 80% of the world’s population live in developing countries where the disease is still rampant. Recent research estimates that RF/RHD affects about 15.6 million people worldwide, with 282 000 new cases and 233 000 deaths each year. There are 2.4 million affected children between 5 and 14 years of age in developing countries, 1 million of whom live in sub-Saharan Africa, making the continent the major RF/RHD hotspot.2