Ethnic Differences for Developing Rheumatic Fever in a Low- Income Group Living in Hawaii

The risk factors responsible for acute rheumatic fever (ARF) are complex, in part, because group A streptococcus (GAS) infection is a prerequisite for this disease. We attempted to differentiate socioeconomic from genetic risk factors by studying subjects in a Hawaii pediatric cardiology clinic who qualified for Medicaid. This ethnically diverse group was unique because they maintained a low socioeconomic but generally healthy lifestyle with more limited risks than those living in extremely impoverished conditions. Methods Questionnaires were administered to consenting subjects in the clinic, who were divided into those diagnosed with ARF (n=26) and those with other (primarily congenital) heart diseases (n=41).