Title : CLINICO-DEMOGRAPHIC PROFILE OF PEDIATRIC ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN A TERTIARY REFERRAL HOSPITAL IN NORTHERN LUZON FROM JANUARY 2020 TO DECEMBER 2024 – A FIVE-YEAR RETROSPECTIVE STUDY
Abstract:
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain significant causes of pediatric morbidity in low-resource settings. Local data on clinical profiles and outcomes in the Philippines remain limited, underscoring the need for updated institutional evidence. This retrospective descriptive study reviewed pediatric ARF and RHD cases seen at Baguio General Hospital and Medical Center (BGHMC) from January 2020 to December 2024. Demographic characteristics, clinical manifestations based on Jones criteria, echocardiographic findings, and 6-month outcomes were collected and analyzed using descriptive statistics. Sixty-four patients were included in this study, 12 (18.75%) had ARF, and 52 (81.25%) had RHD. Most patients were 10–<19 years old (81.25%), with a mean age at diagnosis of 13.22 years; males comprised 57.81%. Nearly half had recurrent tonsillopharyngitis (48.44%), and more than half belonged to financially disadvantaged households. Carditis (65.63%) was the predominant
major criterion, while fever (70.31%) and elevated CRP (60.94%) were the most common minor criteria. All ARF patients and 63.46% of RHD patients had elevated ASO titers. Echocardiography frequently demonstrated mitral regurgitation, both isolated and multivalve. At six-month follow-up, no ARF patients progressed to RHD, and morbidity was minimal. Among RHD patients, congestive heart failure (76.92%) was the leading complication, followed by pneumonia (25%) and pericardial effusion (12.5%). Mortality occurred only among RHD patients, with a rate of 9.62%. Pediatric ARF and RHD cases at BGHMC predominantly affected adolescents and were strongly associated with indicators of socioeconomic disadvantage. Carditis and multivalvular disease were common at presentation, with RHD patients demonstrating significant morbidity and mortality within six months. These findings highlight the need for strengthened early detection, preventive measures, and longitudinal follow-up to mitigate disease progression and outcomes.
Keywords: Rheumatic Heart Disease, Rheumatic Fever, Jones Criteria, Echocardiography
