Rheumatic fever (RF) and rheumatic heart disease (RHD) are nonsuppurative complications of Group A streptococcal pharyngitis due to a delayed immune response. Although RF and RHD are rare in developed countries, they are still major public health problems among children and young adults in developing countries (1–6). The economic effects of the disability and premature death caused by these diseases are felt at both the individual and national levels through higher direct and indirect health-care costs
