The Global Impact of Rheumatic Heart Disease

Rwebembera, Joselyn; Beaton, Andrea; Loizaga, Sarah R de; Rocha, Rodrigo Tavares Lanna; Nakagaayi, Doreen; Ssinabulya, Isaac; Okello, Emmy; Fraga, Clara L.; Galdino, Bruno Fernandes; Nunes, Maria Carmo P.; Nascimento, Bruno Ramos

doi:10.1007/s11886-021-01592-2

Cited by 18 publications

(14 citation statements)

References 79 publications

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“…The ratio of low SDI region to the high SDI region will be more than seven times. This inequality is primarily attributable to regional disparities in educational achievement and access to healthcare (48). Access to cardiac surgical therapy in developing regions is severely restricted due to the scarcity of heart surgery equipment and healthcare workforces (49)(50)(51), resulting in a much higher mortality rate in developing regions than in developed regions.…”

Section: Discussionmentioning

confidence: 99%

The projections of global and regional rheumatic heart disease burden from 2020 to 2030

Tong

Huang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundRheumatic heart disease (RHD) remains the leading cause of preventable death and disability in children and young adults, killing an estimated 320,000 individuals worldwide yearly.Materials and methodsWe utilized the Bayesian age-period cohort (BAPC) model to project the change in disease burden from 2020 to 2030 using the data from the Global Burden of Disease (GBD) Study 2019. Then we described the projected epidemiological characteristics of RHD by region, sex, and age.ResultsThe global age-standardized prevalence rate (ASPR) and age-standardized incidence rate (ASIR) of RHD increased from 1990 to 2019, and ASPR will increase to 559.88 per 100,000 population by 2030. The global age-standardized mortality rate (ASMR) of RHD will continue declining, while the projected death cases will increase. Furthermore, ASPR and cases of RHD-associated HF will continue rising, and there will be 2,922,840 heart failure (HF) cases in 2030 globally. Female subjects will still be the dominant population compared to male subjects, and the ASPR of RHD and the ASPR of RHD-associated HF in female subjects will continue to increase from 2020 to 2030. Young people will have the highest ASPR of RHD among all age groups globally, while the elderly will bear a greater death and HF burden.ConclusionIn the following decade, the RHD burden will remain severe. There are large variations in the trend of RHD burden by region, sex, and age. Targeted and effective strategies are needed for the management of RHD, particularly in female subjects and young people in developing regions.

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Section: Discussionmentioning

confidence: 99%

The projections of global and regional rheumatic heart disease burden from 2020 to 2030

Tong

Huang

et al. 2022

Front. Cardiovasc. Med.

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“…Besides the high burden on the patients’ health, RHD also impacts the economy of each patient, their households, health systems, and governments [ 7 ]. Recently, a scoping review assessing the economic consequences of RHD, in which no studies from LAC fulfilled the eligibility criteria, concluded that most information on RHD costs comes from wealthier nations [ 75 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the global decreased tendency in the number of deaths, RHD continues to burden many low- and middle-income countries due to its long-term cardiovascular complications including heart failure (HF), pulmonary hypertension (PH), atrial fibrillation (AFib), infective endocarditis (IE), and stroke [ 6 7 ]. Multiple health organizations and world-renowned groups of experts have published recommendations and strategies that aim to reduce the burden of RHD worldwide [ 8 9 10 ].…”

Section: Introductionmentioning

confidence: 99%

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

Jaimes-Reyes¹,

Urina-Jassir²,

Urina-Triana

et al. 2022

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Background: Rheumatic heart disease (RHD) disproportionately affects low-income and middle-income countries. Latin America and the Caribbean (LAC) have been less represented in scientific literature. We aimed to describe the epidemiology, burden and implemented screening and prevention strategies of RHD in LAC. Methods:We systematically searched PubMed, Embase, LILACS, and SciELO from 1990 to April 2021. Observational and experimental studies that described data on the epidemiology, burden, or prevention/screening strategies of RHD, regardless of age or language, were included. The risk of bias was assessed by previously published tools depending on their study design. Pre-specified data were independently extracted and presented by each topic (epidemiology, burden, prevention/screening). PROSPERO registration number: CRD42021250043. Results:Forty-eight studies out of 1692 non-duplicate records met the eligibility criteria. They were mainly from Brazil, observational in design, and hospital-based. Data on the epidemiology of acute rheumatic fever (ARF) was not recent (most before 2000) with studies describing decreasing incidence through the years. The prevalence of RHD was described in six studies, ranging from 0.24 to 48 per 1,000 among studies evaluating schoolchildren. Nine studies described data based on admissions, ranging from 0.04% to 7.1% in single-center studies. Twenty-four studies assessed the burden of RHD with most of them reporting mortality rates/proportions and complications such as the need for intervention, atrial fibrillation, or embolism. Six preventive strategies were identified that included educational, register-based, and/or secondary prophylaxis strategies. Three well-established echocardiographic screening studies in Brazil and Peru were identified. Conclusions:Most ARF/RHD research in LAC comes from a single country, Brazil where preventive/screening efforts have been conducted. There was a paucity of data from several countries in the region, reflecting the need for epidemiological studies from more countries in LAC which will provide a better picture of the current situation of ARF/RHD and guide the implementation of preventive strategies. 2 Jaimes-Reyes et al.

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“…Furthermore, a similar finding to the existing literature is that RHD affects mostly young people below the age of 30 years, predominantly women of reproductive age [ 16 , 19 ]. With the adverse impact of RHD on maternal health, it will be valuable to prioritise investments in interventions for the management of RHD in women [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Rheumatic heart disease prevalence in Namibia: a retrospective review of surveillance registers

Shimanda

Söderberg

Iipinge³

et al. 2022

BMC Cardiovasc Disord

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Background Rheumatic heart disease (RHD) is the most commonly acquired heart disease in children and young people in low and middle-income settings. Fragile health systems and scarcity of data persist to limit the understanding of the relative burden of this disease. The aims of this study were to estimate the prevalence of RHD and to assess the RHD-related health care systems in Namibia. Methods Data was retrieved from outpatient and inpatient registers for all patients diagnosed and treated for RHD between January 2010 to December 2020. We used descriptive statistics to estimate the prevalence of RHD. Key observations and engagement with local cardiac clinicians and patients helped to identify key areas of improvement in the systems. Results The outpatient register covered 0.032% of the adult Namibian population and combined with the cumulative incidence from the inpatient register we predict the prevalence of clinically diagnosed RHD to be between 0.05% and 0.10% in Namibia. Young people (< 18 years old) are most affected (72%), and most cases are from the north-eastern regions. Mitral heart valve impairment (58%) was the most common among patients. We identified weaknesses in care systems i.e., lack of patient unique identifiers, missing data, and clinic-based prevention activities. Conclusion The prevalence of RHD is expected to be lower than previously reported. It will be valuable to investigate latent RHD and patient follow-ups for better estimates of the true burden of disease. Surveillance systems needs improvements to enhance data quality. Plans for expansions of the clinic-based interventions must adopt the “Awareness Surveillance Advocacy Prevention” framework supported by relevant resolutions by the WHO.

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The Global Impact of Rheumatic Heart Disease

Cited by 18 publications

References 79 publications

The projections of global and regional rheumatic heart disease burden from 2020 to 2030

The projections of global and regional rheumatic heart disease burden from 2020 to 2030

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

Rheumatic heart disease prevalence in Namibia: a retrospective review of surveillance registers

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