A study of RF/RHD in several regions in the Philippines among schoolchildren aged six to 15 years in 1978 showed a prevalence rate of 0.9 per 1000, about ten times more compared to most western countries. A hospital registry for RF/RHD established in 1978-80 at the Philippine Heart Center and Philippine General Hospital showed a compliance rate to secondary penicillin prophylaxis of 87-90% when the drug was given free. The compliance rate to secondary prophylaxis considerably decreased when penicillin subsidy was discontinued. In another study, a rural hospital registry is feasible utilizing primary health workers in the recognition of RF/RHD. Once the diagnosis is verified, secondary penicillin prophylaxis can be administered by the primary health workers.
An ongoing RF-RHD prevention and control program consists of case finding among schoolchildren aged five to 15 years in two areas near Manila. After initial training on the recognition of RF-RHD, municipal health officers and school physicians examined the schoolchildren for heart murmurs. Those detected to have murmurs are re-examined by cardiologists and patients identified with RF-RHD are registered in the community hospital for secondary penicillin prophylaxis and follow-up. Primary prevention of RF-RHD is also being carried out among schoolchildren thru integration in the school curriculum of basic information about cardiovascular diseases, including rheumatic fever.