الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 87 |  |  |
| | | from | 87 | | |
Abstract
Rheumatic fever and RHD are still major health problems in developing countries and leading causes of acquired heart disease in children and young adults worldwide. Prevention of both primary episodes and recurrences is related to the control of the GAS infections. The individual who has had an attack of RF is at a high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences secondary prevention. The main problem with the different regimens of secondary prophylaxis is compliance. The pain and intolerance related to BPG injection especially if used without local analgesic, cause some individuals to discontinue prophylaxis and may emerge a recurrent of the RF. So, we are on the look-out for safer alternatives with improved patient compliance, the possibility of use of AZT in such cases needs to be evaluated The American Heart Association recommends AZT in 2009 for secondary RF prophylaxis in allergic patients with class of recommendation (Class I, LOE C). A controlled study to assess the efficacy of AZT for secondary RF prophylaxis would help to strength level of recommendation to (Class I, LOE B) and to determine its safety.
Forty patients from RF clinic in AUCH were included in the study and randomly allocated into two groups; 20 patients receiving AZT and 20 patients receiving BPG. Follow-up extend for 12 months; clinically every 2 weeks and serologically and by Echo every four months. Throat culture was done for all patients and liver enzyme and ECG were done for AZT group patients at the beginning and at the end of study.
Occurrence of recurrences of streptococcal throat infections or relapse of RF, changes in the valve condition and severity grading assessed by Echo and changes in the mean and ULN of ASOT all of these items were considered as indicators of efficacy.
Safety and compliance to both regimens regarding drug and visit were assessed and at the end of follow-up assessment satisfaction and cost comparison between both groups were evaluated.