2016 National Rheumatic Fever Week: The status of rheumatic heart disease in South Africa.

There is evidence of early progress in the efforts to eliminate acute rheumatic fever (ARF) and control rheumatic heart disease (RHD) in South Africa. The caseload of ARF and RHD in paediatric units appears to be falling in some provinces such as Gauteng, and the mortality attributed to rheumatic heart disease at a population level has fallen from 1.3/100 000 in 2001 to 0.7/100 000 in 2012. However, the incidence of congestive heart failure due to RHD in adults remains high (~25/100 000/year) in Gauteng Province, and is associated with a high case fatality rate of up to 35% in 6 months. There is a need to intensify the application of comprehensive interventions to enhance the primary and secondary prevention and treatment of ARF/RHD in a registry-based national programme.