Rheumatic Fever: A Disease without Color

Abstract

BackgroundBrazil has approximately 30.000 cases of Acute Rheumatic Fever (ARF) annually. A third of cardiovascular surgeries performed in the country are due to the sequelae of rheumatic heart disease (RHD), which is an important public health problem.Objectivesto analyze the historical series of mortality rates and disease costs, projecting future trends to offer new data that may justify the need to implement a public health program for RF.Methods we performed a cross-sectional study with a time series analysis based on data from the Hospital Information System of Brazil from 1998 to 2016. Simple linear regression models and Holt’s Exponential Smoothing Method were used to model the behavior of the series and to do forecasts. The results of the tests with a value of p < 0.05 were considered statistically significant.Resultseach year, the number of deaths due to RHD increased by an average of 16.94 units and the mortality rate from ARF increased by 215%. There was a 264% increase in hospitalization expenses for RHD and RHD mortality rates increased 42.5% (p-value < 0.05). The estimated mortality rates for ARF and RHD were, respectively, 2.68 and 8.53 for 2019. The estimated cost for RHD in 2019 was US$ 26.715.897,70.Conclusionsaccording to the Brazilian reality, the 1-year RHD expenses would be sufficient for secondary prophylaxis (considering a Benzatin Penicillin G dose every 3 weeks) in 22.574 people for 10 years. This study corroborates the need for public health policies aimed at RHD.

Current Situation of Acute Rheumatic Fever and Rheumatic Heart Disease in Latin America and the Caribbean: A Systematic Review

“…Our search yielded a total of 2431 records of which 1692 were screened by title/abstract after duplicates were removed. One hundred seventy-nine records were sought for retrieval and ultimately 48 studies fulfilled the eligibility criteria [ 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 ]. A PRISMA [ 11 ] flow diagram of our search strategy and reasons for the exclusion of full-text articles can be seen in Figure 1 .…”

“…Seven studies reported RHD mortality regardless of their treatment; five were from Brazil [ 30 33 37 49 63 ], while the other two were from Peru [ 54 ] and Venezuela [ 34 ]. Studies reported data with different measures (e.g., proportions, rates) with four of them reporting mortality rates.…”

Prótese Mecânica X Prótese Biológica: Uma Decisão Individualizada e Compartilhada

“…On the other hand, 22% of the study population had rheumatic disease, the most prevalent etiology of valve disease in Brazil. 2 The authors found no difference in mortality rates after 10 years of follow-up; however, the implantation of a mechanical prosthesis was associated with a lower rate of reoperation (with no reoperation in the mechanical prosthesis group). When analyzing specifically the bioprosthesis reoperations, patients under 30 years old had the highest rates, compared to those older than 50 years, and even to patients between 30 and 49 years of age.…”

Endocardite Infecciosa: Ainda mais Desafios que Certezas

“…Um declínio na doença valvar reumática foi observado nas últimas décadas, [14][15][16][17] com a etiologia degenerativa como a causa mais comum em países desenvolvidos. No entanto, a carga da doença valvar reumática persiste em países de rendas baixa e média, com prevalência (a doença afeta até 7 em 1000 crianças escolares no Brasil, versus 0,1-0,4 em 18 e mortalidade (275 mil mortes por ano no mundo) significativas. 17 Um estudo recente de Glaser et al 19 indicou que as bioprósteses têm maior risco de infecção em comparação a válvulas mecânicas, mas mais estudos ainda são necessários.…”