“…Hospital admission data [Table 1] show a decline in admission rates of RF/RHD overtime period. RF/RHD accounted for 30%–50% of total admissions until the early 1980s, and it declined to 5%–26% in the late 1990s 11, 12, 13, 14, 15, 16, 17, 18, 19. Whether the declining trends in admission rate truly reflects the decreasing incidence is much to be debated.…”