{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:19:33Z","timestamp":1790806773850,"version":"4.1.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Recent evaluation of rheumatic heart disease (RHD) mortality demonstrates disproportionate disease burden within the United States. However, there are few contemporary data on US children living with acute rheumatic fever (ARF) and RHD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Twenty\u2010two US pediatric institutions participated in a 10\u2010year review (2008\u20132018) of electronic medical records and echocardiographic databases of children 4 to 17\u00a0years diagnosed with ARF\/RHD to determine demographics, diagnosis, and management. Geocoding was used to determine a census tract\u2010based socioeconomic deprivation index. Descriptive statistics of patient characteristics and regression analysis of RHD classification, disease severity, and initial antibiotic prescription according to community deprivation were obtained. Data for 947 cases showed median age at diagnosis of 9\u00a0years; 51% and 56% identified as male and non\u2010White, respectively. Most (89%) had health insurance and were first diagnosed in the United States (82%). Only 13% reported travel to an endemic region before diagnosis. Although 96% of patients were prescribed secondary prophylaxis, only 58% were prescribed intramuscular benzathine penicillin G. Higher deprivation was associated with increasing disease severity (odds ratio, 1.25; 95% CI, 1.08\u20131.46).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The majority of recent US cases of ARF and RHD are endemic rather than the result of foreign exposure. Children who live in more deprived communities are at risk for more severe disease. This study demonstrates a need to improve guideline\u2010based treatment for ARF\/RHD with respect to secondary prophylaxis and to increase research efforts to better understand ARF and RHD in the United States.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020992","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T08:58:24Z","timestamp":1628153904000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":41,"title":["Rheumatic Heart Disease in the United States: Forgotten But Not Gone"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1001-273X","authenticated-orcid":false,"given":"Sarah R.","family":"de Loizaga","sequence":"first","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Arthur","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences\/Arkansas Children's Hospital Little Rock AR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhawna","family":"Arya","sequence":"additional","affiliation":[{"name":"Seattle Children's Hospital\/University of Washington School of Medicine Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Beckman","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-4303","authenticated-orcid":false,"given":"Wubishet","family":"Belay","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children's Hospital at Vanderbilt Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cole","family":"Brokamp","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"University of Cincinnati Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nak","family":"Hyun Choi","sequence":"additional","affiliation":[{"name":"Morgan Stanley Children's Hospital of New York PresbyterianColumbia University Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Connolly","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. 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