XXXX prevention program: long-term evolution and outcomes.

@entity4789 @entity1 @entity75 @entity409 @entity338 @entity204 @entity2401
This investigation aims to analyze the profile of long-term evolution of @entity4789 in @entity1 and adolescents and outcomes after the control of recurrences. The cohort involved 702 @entity1 followed from 1.3 to 16.9   years covering the two periods, before and after the implementation of a prevention program. Besides the establishment of the Reference Center in the State of Minas Gerais and the implementation of strategies to promote the compliance to prophylaxis, a project for education of health professionals was carried out in 23 cities. In addition to the clinical and epidemiological profile, the severity of the disease was analyzed. Mixed lesions were found in 27.1%, @entity338 in 72.9%, and complete regression of the @entity75 was seen in 34.4% of the @entity1 , mostly presenting @entity409 . The recurrence rate per @entity1 -year was 0.058 and out of a total of 85 recurrences, 21.4% occurred in the first and 7.5% in the second period. More severe degrees of @entity2401 and significant valvar sequels presented a higher prevalence in @entity1 with recurrences. The comparative analysis between the two periods showed no changes regarding the age at the primary attack, gender, type, and site of @entity75 and affected joints; however, important modifications in the indices of severity were observed after the control of recurrences. A significant decrease in the prevalence of severe @entity2401 , obstructive valvar sequels, hospital admissions, surgical approach, and @entity204 was seen. This investigation showed that although the clinical profile of presentation remains unchanged, the control of repeated attacks can improve the morbimortality rates. In this context, the secondary prophylaxis should be the first priority in the control of the disease in developing countries, taking into account the difficulties found for effective primordial and primary prevention.
