Poor kids' hearts in peril

Rheumatic fever could be stamped out in one generation if children with "strep throat" were given a penicillin injection.

And getting rid of rheumatic fever would lead to a reduction in rheumatic heart disease.

But this is not happening because of a middle-class backlash against antibiotics, said the head of the department of medicine at the University of Cape Town, Professor Bongani Mayosi, whose research into rheumatic heart disease was recently published in the European Heart Journal.

He and his team found that the fear of "superbugs", whose rise is attributed to the overuse of antibiotics, is harming most of this country's children, who are at much higher risk of contracting rheumatic heart disease than their wealthier counterparts because of their living conditions.

Rheumatic heart disease occurs when sore throats caused by bacterial infection are neglected and develop into rheumatic fever.

"If you are having repeated episodes of sore throat and rheumatic fever, you will probably get heart disease," he said, explaining that the body's immune system sometimes attacked itself.

"But if we gave children with a sore throat one penicillin injection we would stop rheumatic fever within a generation.

"It is utterly preventable and any country in which it is [not rare] should be ashamed of itself," Mayosi said.

But Khutso Rabothata, of the Department of Health, said: "We are fully aware that many cases of rheumatic fever could be prevented if antibiotics were given timeously for strep throats.

"Health workers are, however, often cautious about giving antibiotics because their overuse is dangerous and not every sore throat is a strep throat."

But, Mayosi said, the accepted guidelines on the use of antibiotics were based on the profile of middle-class children, who are in the minority, and not on youngsters living in poor conditions.

The risk of these children dying of heart disease was much greater than that of their being infected by superbugs, the professor said.

These children, he said, were more likely to get strep throat but had less access to healthcare and often could not go to a clinic for treatment for a sore throat.

"Children in Constantia," he said, "are less likely to get strep throat and if they do they will go to a doctor."

Jessica Byrne of the Heart and Stroke Foundation SA, said the most commonly acquired heart disease in children in sub-Saharan Africa was a consequence of rheumatic fever.