Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jun 10;4(6):e004844.
doi: 10.1136/bmjopen-2014-004844.

Incidence, prevalence and outcomes of rheumatic heart disease in South Africa: a systematic review protocol

Liesl Zühlke  1 , David Watkins  2 , Mark E Engel  3
Affiliations

Incidence, prevalence and outcomes of rheumatic heart disease in South Africa: a systematic review protocol

Liesl Zühlke et al. BMJ Open. .

Abstract

Background: Rheumatic heart disease (RHD) is the principal cause of acquired heart disease affecting people living largely in poverty and deprived conditions. Sub-Saharan Africa was long thought to be the hotspot of the disease but recent reports suggest that this is no longer the case. South Africa is the leading economic force within this region yet contends with continued extreme income disparities. It is of interest to ascertain whether the strides that have been made in healthcare since the democratic transition in South Africa have translated into decreased RHD burden. We therefore propose to review the current best estimates of incidence of newly diagnosed RHD and prevalence of existing RHD within the past two decades. We also propose to characterise the fatal and non-fatal outcomes of RHD and identify any trends in this period.

Methods and design: We plan to search electronic databases and reference lists of relevant articles published from April 1994 to April 2014. Studies will be included if they estimated one of the following epidemiological measures: incidence, prevalence, remission rate, relative risk of mortality or cause-specific mortality. For studies deemed eligible for inclusion, we will assess overall study quality, reliability and risk of bias using design-specific criteria. We will extract data using a standardised form and perform descriptive and quantitative analysis to assess RHD prevalence, mortality and morbidity. This review protocol is registered in the PROSPERO International Prospective Register of systematic reviews, registration number CRD42014007072.

Dissemination: Our planned review will provide healthcare providers, public health officials and policymakers with pooled contemporary data regarding RHD, in particular regarding the effect the new political dispensation has had on the burden of this preventable disease within South Africa. In addition, these important country-specific data could influence policy decisions regarding prevention, management and control of RHD.

Keywords: Epidemiology; Public Health.

PubMed Disclaimer

References

    1. Marijon E, Mirabel M, Celermajer DS, et al. Rheumatic heart disease. Lancet 2012;379:953–64 - PubMed
    1. Zühlke LJ, Steer AC. Estimates of the global burden of rheumatic heart disease. Global Heart 2013;8:189–95 - PubMed
    1. McLaren MJ, Hawkins DM, Koornhof HJ, et al. Epidemiology of rheumatic heart disease in black school children of Soweto, Johannesburg. BMJ 1975;3:474–8 - PMC - PubMed
    1. Marcus RH, Sareli P, Pocock WA, et al. The spectrum of severe rheumatic mitral valve disease in a developing country. Correlations among clinical presentation, surgical pathologic findings, and hemodynamic sequelae. Ann Intern Med 1994;120:177–83 - PubMed
    1. McLaren MJ, Markowitz M, Gerber MA. Rheumatic heart disease in developing countries: the consequence of inadequate prevention. Ann Intern Med 1994;120:243–5 - PubMed

Publication types

LinkOut - more resources