Global burden of rheumatic heart disease: trends from 1990 to 2019

Ou, Zejin; Yu, Danfeng; Liang, Yuanhao; Wu, Jinhua; He, Huan; Li, Yongzhi; He, Wenqiao; Gao, Yuhan; Wu, Fei; Chen, Qing

doi:10.1186/s13075-022-02829-3

Cited by 28 publications

(26 citation statements)

References 46 publications

(41 reference statements)

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“…ARF and RHD remain a problem that cannot be ignored in economically developed countries such as Israel and Italy ( 23 ). The global prevalence of RHD increased by 70.49% between 1990 and 2019 ( 24 ). Africa and south Asia have large burden of ARF and RHD.…”

Section: Resultsmentioning

confidence: 99%

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

Liang

et al. 2023

Front. Cardiovasc. Med.

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IntroductionThe incidences of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), which were leading causes of death in children in the 1920s, have decreased substantially. Considering the recent resurgence of scarlet fever and increased incidence of streptococcal pharyngitis in children, an investigation of the current status of ARF and RHD may be worthwhile.ObjectiveTo summarize the prevalence trends, pathogenic factors, and prevention strategies for ARF and RHD in children.MethodsA selective search of literature published between January 1920 and February 2023 was done in PubMed, using the terms “acute rheumatic fever”, “rheumatic heart disease”, “group A Streptococcus”, “pharyngitis”, “pharyngeal tonsillitis”, “scarlet fever”, “impetigo”, “obstructive sleep apnea syndrome” and “child”.ResultsOvercrowded homes and inadequate sanitation led to recurrent group A streptococcal infection, and the causal relationship between group A streptococcal infection and ARF/RHD was well established. Streptococcal infectious diseases, such as group A streptococcal pharyngeal tonsillitis, SF, impetigo, and obstructive sleep apnea syndrome, were associated with the occurrence of ARF and RHD. ARF and RHD were still prevalent in young people of developing countries and economically poor populations of high-income countries. Universal disease registration systems were critical to locating disease outbreaks, tracking disease transmission, and identifying high-risk populations. Four-level prevention strategies were effective in reducing the incidence and mortality of ARF and RHD.ConclusionsRegistry and preventive measures for ARF and RHD should be strengthened in areas of dense population; poor sanitation; resurgence of SF; and high incidence of streptococcal pharyngitis, impetigo, and obstructive sleep apnea syndrome.

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Section: Resultsmentioning

confidence: 99%

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

Liang

et al. 2023

Front. Cardiovasc. Med.

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“…According to worldwide and regional research, the prevalence of RHD in women is consistently higher than in men [29][30][31]. Global burden studies reveal that the age group between 25 and 29 years old had the highest frequency of RHD in 2019 [32]. From 1990 to 2019, RHD prevalence was primarily concentrated between the ages of 15 and 49 [31].…”

Section: Flow-chart Of Determinants Relating To Healthcare-related Co...mentioning

confidence: 99%

Disparity of secondary prevention among patients with rheumatic heart disease: A longitudinal study in Uganda

Xu,

Chu,

Miao

et al. 2024

Preprint

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Background: Rheumatic heart disease (RHD) is most prevalent in socially disadvantaged settings, placing a severe burden on patients and their households. The study aims to investigate the disparity of healthcare costs, including financial and time costs, among RHD patients in Uganda. Methods: We enrolled 54 RHD households from the Uganda National RHD Registry between June 2019 and February 2021. The patients were interviewed in baseline and 12-month follow-up surveys. A random-effect model was applied to examine the disparity of RHD financial and time costs. Our primary outcomes are the total outpatient costs for RHD patients? most recent visit, consisting of direct medical costs, direct non-medical costs, and time costs. Results: Following the COVID-19 pandemic, the total financial cost of outpatient visits for RHD patients increased by 9 USD on average (P<0.01), with the change primarily driven by non-medical costs such as transportation and food (5.8 USD, P<0.05). Direct medical costs also increased significantly in the pandemic, with an average increase of 3.2 USD (P<0.1). Compared with their counterparts, non-medical costs were higher for patients with poor infrastructure, with less education, who were older, and who were male. Patients with employment experienced a higher time cost than those without (3.3 hours, P<0.01). Conclusions: The COVID-19 pandemic significantly increased RHD outpatient costs, mainly caused by the increase in non-medical costs. Our study implies that improving infrastructure, investing in education, and providing employees with time to seek care have the potential to reduce non-medical barriers to RHD secondary prevention.

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“…During 1990–2019, the distribution of RHD varied markedly across the globe. In some LMICs, RHD risk is widespread, with only pockets of the population protected from infection 3. At the other extreme are HICs, where RHD has largely disappeared 9.…”

Section: Key Research Topic 1: Global Analysis Of Disease Incidence P...mentioning

confidence: 99%

“…ARF typically occurs in children and adolescents (aged 5–15) 2. In 2019, the Global Burden of Disease Study estimated that there were 2.8 (2.2–3.5) million new cases of RHD annually, with 40.5 (32.1–50.1) million total cases, leading to 310 000 deaths, the vast majority occurring in low and middle-income countries (LMICs) 3. While there was a decline in RHD deaths and lost disability-adjusted life years (DALYs) from 1990 to 2019,4 the burden of disease remains substantial, suggesting that considerable effort should be applied to the prevention and control of this disease.…”

Section: Introductionmentioning

confidence: 99%

Research priorities for the primordial prevention of acute rheumatic fever and rheumatic heart disease by modifying the social determinants of health

Baker,

Masterson,

Shung-King

et al. 2023

BMJ Glob Health

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The social determinants of health (SDH), such as access to income, education, housing and healthcare, strongly shape the occurrence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) at the household, community and national levels. The SDH are systemic factors that privilege some more than others and result in poverty and inequitable access to resources to support health and well-being. Primordial prevention is the modification of SDH to improve health and reduce the risk of disease acquisition and the subsequent progression to RHD. Modifying these determinants using primordial prevention strategies can reduce the risk of exposure to Group A Streptococcus, a causative agent of throat and skin infections, thereby lowering the risk of initiating ARF and its subsequent progression to RHD.This report summarises the findings of the Primordial Prevention Working Group-SDH, which was convened in November 2021 by the National Heart, Lung, and Blood Institute to assess how SDH influence the risk of developing RHD. Working group members identified a series of knowledge gaps and proposed research priorities, while recognising that community engagement and partnerships with those with lived experience will be integral to the success of these activities. Specifically, members emphasised the need for: (1) global analysis of disease incidence, prevalence and SDH characteristics concurrently to inform policy and interventions, (2) global assessment of legacy primordial prevention programmes to help inform the co-design of interventions alongside affected communities, (3) research to develop, implement and evaluate scalable primordial prevention interventions in diverse settings and (4) research to improve access to and equity of services across the RHD continuum. Addressing SDH, through the implementation of primordial prevention strategies, could have broader implications, not only improving RHD-related health outcomes but also impacting other neglected diseases in low-resource settings.

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Global burden of rheumatic heart disease: trends from 1990 to 2019

Cited by 28 publications

References 46 publications

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

Disparity of secondary prevention among patients with rheumatic heart disease: A longitudinal study in Uganda

Research priorities for the primordial prevention of acute rheumatic fever and rheumatic heart disease by modifying the social determinants of health

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