While the incidence and prevalence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) have been decreasing in developed nations since the early 1900s, they continue to be major causes of morbidity and mortality among children in developing nations. Aim of the study: The aim of the present study is to evaluate the characteristics of children with ARF in two governorates in upper Egypt. Materials and Methods: The study was conducted in pediatric cardiology clinics in pediatric departments of Assiut and Sohag University hospitals. The study included 160 children aged 5-15 years old with ARF, eighty from each pediatric department of Assuit and Sohag University Hospitals. A control group of apparently healthy children of same number for each group was included. Three tools for collecting data were used in this study: tool one is an assessment questionnaire of children and parents knowledge about rheumatic fever (RF). Tool two: Assessment of socioeconomic condition of families. Tool three included anthropometric measurements of children. Results: ARF was more common among male children (62.5%) than females (37.5%) in Assiut compared with Sohag group (41.3%, 58.7% respectively) (P=0.002). Children with RF were more prevalent among families living in rural areas in Assiut and Sohag (78.8% and 60% respectively) than urban (21.25% and 40% respectively) (P=0.008). High percentages of illiteracy of the fathers of children with RF in Assiut (58.8%) and Sohag (62.5%) and similarly were the mothers in Assiut and Sohag (87.5% and 77.5% respectively). There was a significant difference between low socio-economic class (200-400 L.E) of families in Assiut and Sohag and RF (P=0.009).. The Majority of fathers of the two study groups in Assiut and Sohag were workers and farmers (85.0% and 71.25% respectively). Also the majority of mothers in both groups were housewives (95.0% and 82.5% respectively). About one quarter in Sohag group (23.75%) had a family history of RF compared to 21.25% in Assiut. There was a lack of parents' knowledge about RF including definition, causes, signs and symptoms, treatment, persons at risk of RF, its complications and caring of child with RF.
Conclusion: RF occurs equally in both sexes to some extent, more common among rural, crowded, low socioeconomic families with high percentage of illiteracy, unemployment, and lack of knowledge about RF among parents.