Acute Rheumatic Fever among Primary School Students in Harari Region, Eastern Ethiopia

Abstract

Background: In many developed countries, acute rheumatic fever is eradicated through strong health promotion and prevention efforts; yet, it continues to cause serious health problems in many developing countries including Ethiopia. The main aim of the study was to assess the prevalence and factors associated with acute rheumatic fever among primary school students in Harari region, Eastern Ethiopia. Methodology: A cross-sectional study was conducted among students of four primary schools from November, 2015 to April, 2016.  Data were collected according to modified Jones criteria with confirmation of preceding infection by anti-streptolysin –O titre. Factors associated with the outcome were identified using logistic regression. Odds ratios and the corresponding confidence intervals were used to report the findings. Results: Out of 1739 school children with the mean age of 11.5 years (6-19 years), 21 had Acute Rheumatic Fever (ARF). The two week prevalence of acute rheumatic fever and tonsillopharyngitis were 21/1739 (1.2%) and 231/1739 (13.2%) respectively.  Regarding awareness towards causes of tonsillitis, 78% perceived consumption of cold foods and drinks. Factors associated with ARF were maternal illiteracy (AOR 5.54, 95% CI 1.07, 28.662) and urban school (AOR 0.254, 95% CI 0.084, 0.769). Conclusion: The prevalence of ARF among primary school children was high. School health education program focused on acute rheumatic fever causes and consequences are needed to increase awareness among children and their parents.