INCIDENCE OF RHEUMATIC-FEVER AND PREVALENCE OF RHEUMATIC HEART-DISEASE IN INDIA

Rheumatic heart disease (RHD) has been documented in Indian medical li terature since the early nineteenth century, contrary to the popular b elief that rheumatic fever (RF) and its sequelae were exclusively prev alent in temperate climates until the early twentieth century. Rheumat ic heart disease has, in the past 50 years, emerged as a major contrib utor to cardiovascular morbidity in India. Despite the paucity of clea r information regarding secular trends, the few available community su rveys indicate that there are at present more than 1 million patients with RHD. Even a conservative estimate of the incidence of RP suggests that at least 50 000 new episodes occur every year. The younger age o f onset (juvenile RHD) seen in India is a special feature of both publ ic health and clinical importance. These patterns of RF and RHD, which may be similar to those in other developing countries, underscore the importance of effective public health strategies for prevention and c ontrol.