A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town

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dc.contributor.advisorMayosi, Bonganien_ZA
dc.contributor.authorEngel, Mark Een_ZA
dc.date.accessioned2014-07-29T09:03:22Z
dc.date.available2014-07-29T09:03:22Z
dc.date.issued2012en_ZA
dc.descriptionIncludes abstract.
dc.descriptionIncludes bibliographical references.
dc.description.abstractRheumatic Heart Disease (RHD) is a post-infectious immune disease ascribed to an interaction between a rheumatogenic strain of group A streptococcus, a susceptible host who lives in poor social conditions with limited access to medical facilities. The disease process begins with repeated group A streptococcal (GAS) infections, which, subsequently result in acute rheumatic fever (ARF). In the absence of intervention, repeated bouts of ARF in turn, may result in progression to RHD, particularly in those ARF patients with cardiac involvement. The prevalence of ARF and RHD in developed countries has shown considerable decline during the last century, largely attributed to improved living conditions and access to healthcare. Epidemiological data from developing countries, while scant, indicate a continued high prevalence of GAS-positive pharyngitis and RHD. Furthermore, while much is known about the social factors and the microbial agent that predispose individuals to ARF, little progress has been made in elucidating genetic susceptibility factors that are reproducible in different populations. This thesis aimed to establish determinants of RHD as well as to document the prevalence of RHD in South African school children. The specific objectives of each study component were as follows: To derive quantitative estimates of the size of the genetic contribution to the risk of developing ARF/RHD. To determine the prevalence of GAS carriage and emm strains of GAS isolates among asymptomatic children enrolled in primary and secondary school. To describe the epidemiology of GAS among 3- to 15-year old children with pharyngitis attending primary health care facilities. To develop a clinical prediction rule for diagnosis of GAS throat infection that is valid for children aged 5-15 years in the primary care setting within the South African context. To determine the prevalence of echocardiographically-proven rheumatic heart disease in school children.en_ZA
dc.identifier.apacitationEngel, M. E. (2012). <i>A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/3381en_ZA
dc.identifier.chicagocitationEngel, Mark E. <i>"A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2012. http://hdl.handle.net/11427/3381en_ZA
dc.identifier.citationEngel, M. 2012. A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Engel, Mark E AB - Rheumatic Heart Disease (RHD) is a post-infectious immune disease ascribed to an interaction between a rheumatogenic strain of group A streptococcus, a susceptible host who lives in poor social conditions with limited access to medical facilities. The disease process begins with repeated group A streptococcal (GAS) infections, which, subsequently result in acute rheumatic fever (ARF). In the absence of intervention, repeated bouts of ARF in turn, may result in progression to RHD, particularly in those ARF patients with cardiac involvement. The prevalence of ARF and RHD in developed countries has shown considerable decline during the last century, largely attributed to improved living conditions and access to healthcare. Epidemiological data from developing countries, while scant, indicate a continued high prevalence of GAS-positive pharyngitis and RHD. Furthermore, while much is known about the social factors and the microbial agent that predispose individuals to ARF, little progress has been made in elucidating genetic susceptibility factors that are reproducible in different populations. This thesis aimed to establish determinants of RHD as well as to document the prevalence of RHD in South African school children. The specific objectives of each study component were as follows: To derive quantitative estimates of the size of the genetic contribution to the risk of developing ARF/RHD. To determine the prevalence of GAS carriage and emm strains of GAS isolates among asymptomatic children enrolled in primary and secondary school. To describe the epidemiology of GAS among 3- to 15-year old children with pharyngitis attending primary health care facilities. To develop a clinical prediction rule for diagnosis of GAS throat infection that is valid for children aged 5-15 years in the primary care setting within the South African context. To determine the prevalence of echocardiographically-proven rheumatic heart disease in school children. DA - 2012 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town TI - A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town UR - http://hdl.handle.net/11427/3381 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/3381
dc.identifier.vancouvercitationEngel ME. A study of determinants and prevalence of Rheumatic Heart Disease in Cape Town. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2012 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/3381en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherMedicineen_ZA
dc.titleA study of determinants and prevalence of Rheumatic Heart Disease in Cape Townen_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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