Prevalence of Rheumatic Heart Disease

Prevalence of Rheumatic Heart Disease


Some patients with untreated streptococcal
pharyngitis develop acute rheumatic fever, which can result in lifelong rheumatic heart
disease. In recent decades, the incidence of rheumatic
fever has declined dramatically in higher-income countries owing to the treatment of streptococcal
infections; implementation of World Health Organization guidelines has also led
to reductions in incidence of rheumatic heart disease in many other countries. What then is the current global burden of
rheumatic heart disease? As part of the 2015 Global Burden of Disease
Study, investigators used multiple sources of data including vital statistics registries,
the published medical literature, and administrative data sets, and then employed epidemiologic
modeling techniques to estimate the global, regional, and national prevalence of rheumatic
heart disease, as well as death rates and disability-adjusted life years attributable
to it from 1990 to 2015. During that period, the global age-standardized death
rate from rheumatic heart disease decreased from 9.2 per 100,000 to 4.8 per 100,000, a change of
47.8%. The age-standardized
prevalence of rheumatic heart disease declined significantly in several regions; in 2015,
the estimated age-standardized prevalence was 444 per 100,000 in countries with endemic
disease and 3.4 per 100,000 in non-endemic countries. The highest rates of age-standardized death
due to rheumatic heart disease, prevalence of rheumatic heart disease, and disability-adjusted
life years due to rheumatic heart disease were in Oceania, South Asia, and Central Sub-Saharan
Africa. The investigators conclude that the health-related
burden of rheumatic heart disease has declined in most countries, but the condition persists
in some of the world’s poorest regions. Full study results are available at NEJM.org