Study of Follow-Up of Children Recommended for Rheumatic Fever Prophylaxis

Abstract

This report describes the result of a follow-up study done in 1955 on children seen in the New York City Health Departments cardiac consultation service clinics in 1954 who were recommended for placement on a prophylaxis regime to prevent recurrences of rheumatic fever. Of 444 children under care of a known treatment agency, 231 (52%) were still under such medical care; 60% of these children were on prophylaxis. Of 213 children no longer under care of the original treatment agency, 19% were on prophylaxis. Such original treatment agencies as approved hospital clinics and qualified specialists were more successful in regard to prophylaxis (74% and 67%, respectively) than other hospitals and physicians. Almost 3/4 of children placed on prophylaxis were on a regime considered adequate or more than adequate, according to recommendations of the American Heart Association. Penicillin per os was most commonly used. Reasons for failure of the program are (1) failure of medical treatment agency to agree with recommendations regarding prophylaxis; (2) failure of family due to lack of cooperation and economic reasons; (3) failure of health department to perform an effective interpretative and educational function, both as to families and medical treatment agencies.