Contribution to the Study of the Incidence of Post-Streptococcal Complications in Republic Central African Republic from 2015 to 2018

Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present study aims to determine the incidence rate of AAR cases and its complications. Methodology: This was a retrospective and analytical study over a period of 4 years (from January 2015 to December 2018) at the National Laboratory of Clinical Biology and Public Health (LNBCSP) in Bangui. It focused on samples concerning the diagnosis of AAR and patient files seen in consultation in the capital’s reference health establishments. Laboratory registers and patient consultation files were used to collect data. They were entered into Excel 2010 to be analyzed with Epi Info 7. A univariate analysis by logistic regression, Ficher’s exact test, and chi2 at the 5% threshold (p < 0.05) were used to compare the proportions to analyze the association between qualitative and quantitative variables. Results: We analyzed 94 cases meeting Jones’s criteria. The ages of the patients ranged from 18 to 85 years (mean age 52 years and mode 45 years). The incidence rate of AAR for the female sex was higher than that of the male sex during the study period (p > 0.05). It went from 166.6 in 2015 to 200 in 2016 and 2018 cases of AAR per 1000 people per year. The average incidence rate was 296.18 cases of AAR per 1000 people per year. The average incidence rate was 223.5 cases of AAR per 1000 people per year for joint damage. Joint damage represented 80.85% (RR = 0.62; Chi2 = 4.88; 95% CI [0.39-0.97]; p < 0.01). Univariate analyses showed a statistically significant association (p < 0.05) with clinical signs and markers of inflammation. Accelerated sedimentation speed (ESR) is associated with a risk of joint complication of AAR (RR = 1.17). Polyarthrisis resumes in 89.47% of cases (RR = 4.22; Chi2 = 25.34; 95% CI [2.14-8]; p < 0.001). Polyarthrisis is read 4 times and associated with the risk of occurrence of AAR complications. Other inflammation markers are compatible with protective effect (RR < 1). The average incidence rate of cardiac damage was 57.7 cases of AAR per 1000 people per year for cardiac damage. Conclusion: The study allowed data on the impact rate and complications of the AAR in Bangui. Special attention to data management will help produce a complete result on the problem. Joint complications predominated. Sustaining an effective surveillance system and preventing infection would help reduce the risk of AAR occurrence.