A Public Health Program for Children with Heart Disease or Rheumatic Fever

Abstract

An evaluation of a pilot program for the identification and follow-up of children with rheumatic fever or heart disease in one borough of New York City, using an active register as a tool of follow-up and a source of data on incidence and prevalence of rheumatic fever and heart disease in the area. Between 15% and 26% of children reported as having heart disease or rheumatic fever were found to have neither. The proportion overdiagnosed varied with the diagnosis, with the smallest proportion of overdiagnosis in the congenital group. Children with histories of rheumatic fever constitute the majority of those in need of public health follow -up to insure the continuous use of prophylaxis against recurrent attacks. The program has stimulated the development of improved services for children with heart disease and rheumatic fever in the area served.