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
. 2022 Jun 11;24(1):138.
doi: 10.1186/s13075-022-02829-3.

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

Zejin Ou  1   2 , Danfeng Yu  3 , Yuanhao Liang  4 , Jinhua Wu  5 , Huan He  4 , Yongzhi Li  4 , Wenqiao He  4 , Yuhan Gao  4 , Fei Wu  4 , Qing Chen  6
Affiliations

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

Zejin Ou et al. Arthritis Res Ther. .

Abstract

Background: Rheumatic heart disease (RHD) is a critical public health issue worldwide, and its epidemiological patterns have changed over the decades. This article aimed to estimate the global trends of RHD, and attributable risks from 1990 to 2019.

Methods: Data on RHD burden were explored from the Global Burden of Disease Study 2019. Trends of the RHD burden were estimated using the estimated annual percentage change (EAPC) and age-standardized rate (ASR).

Results: During 1990-2019, increasing trends in the ASR of incidence and prevalence of RHD were observed worldwide, with the respective EAPCs of 0.58 (95% confidence interval [CI] 0.52 to 0.63) and 0.57 (95%CI 0.50 to 0.63). Meanwhile, increasing trends commonly occurred in low and middle Socio-Demographic Index (SDI) regions and countries. The largest increasing trends in the ASR of incidence and prevalence were seen in Fiji, with the respective EAPCs being 2.17 (95%CI 1.48 to 2.86) and 2.22 (95%CI 1.53 to 2.91). However, death and disability-adjusted life years (DALYs) due to RHD showed pronounced decreasing trends of ASR globally, in which the EAPCs were - 2.98 (95%CI - 3.03 to - 2.94) and - 2.70 (95%CI - 2.75 to - 2.65), respectively. Meanwhile, decreasing trends were also observed in all SDI areas and geographic regions. The largest decreasing trends of death were observed in Thailand (EAPC = - 9.55, 95%CI - 10.48 to - 8.61). Among the attributable risks, behavioral risk-related death and DALYs caused by RHD had pronounced decreasing trends worldwide and in SDI areas.

Conclusions: Pronounced decreasing trends of death and DALYs caused by RHD were observed in regions and countries from 1990 to 2019, but the RHD burden remains a substantial challenge globally. The results would inform the strategies for more effective prevention and control of RHD.

Keywords: Age-standardized rate; Disability-adjusted life years; Estimated annual percentage change; Global Burden of Disease; Rheumatic heart disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The trends in incidence, prevalence, death, and DALYs of RHD at the global and regional levels, 1990–2019. RHD, rheumatic heart disease; SDI, sociodemographic index; DALYs, disability-adjusted life years
Fig. 2
Fig. 2
The incident number of RHD in age groups, and in SDI areas and geographic regions, 1990-2019. The incident number in age groups (A), SDI areas (B), and geographical regions (C), respectively. RHD, rheumatic heart disease; SDI, sociodemographic index
Fig. 3
Fig. 3
The ASRs, percentage changes, and EAPCs of RHD incidence at the national level, 1990–2019. A The ASRs in 2019. B The percentage changes in the number between 2000 and 2019. C The EAPCs in countries/territories. Countries/territories with an extreme value were annotated. RHD, rheumatic heart disease; ASR, age-standardized rate; EAPC, estimated annual percentage change
Fig. 4
Fig. 4
The association between EAPCs and ASRs in 1990 of RHD at the national level. The EAPCs of incidence (A), prevalence (B), death (C), and DALYs (D) had positive associations with ASR in 1990. The association was calculated with Pearson correlation analysis. The size of the circle increased with the corresponding numbers in 1990. RHD, rheumatic heart disease; EAPC, estimated annual percentage change; ASR, age-standardized rate; DALYs, disability-adjusted life years
Fig. 5
Fig. 5
The association between EAPCs of RHD and HDI in 2019 at the national level. The EAPCs of incidence (A), prevalence (B), death (C), and DALYs (D) had negative associations with HDI in 2019. The association was calculated with Pearson correlation analysis. The size of the circle increased with the corresponding numbers in 2019. RHD, rheumatic heart disease; EAPC, estimated annual percentage change; ASR, age-standardized rate; DALYs, disability-adjusted life years
See this image and copyright information in PMC

References

    1. Zuhlke L, Karthikeyan G, Engel ME, Rangarajan S, Mackie P, Cupido-Katya Mauff B, Islam S, Daniels R, Francis V, Ogendo S, et al. Clinical outcomes in 3343 children and adults with rheumatic heart disease from 14 low- and middle-income countries: two-year follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY Study) Circulation. 2016;134(19):1456–1466. doi: 10.1161/CIRCULATIONAHA.116.024769. - DOI - PubMed
    1. GBD 2013 Mortality Causes of Death Collaborators Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–171. doi: 10.1016/S0140-6736(14)61682-2. - DOI - PMC - PubMed
    1. Gordis L. The virtual disappearance of rheumatic fever in the United States: lessons in the rise and fall of disease. T. Duckett Jones memorial lecture. Circulation. 1985;72(6):1155–1162. doi: 10.1161/01.CIR.72.6.1155. - DOI - PubMed
    1. Oliver J, Osowicki J, Cordell B, Hardy M, Engelman D, Steer AC. Incidence of acute rheumatic fever and rheumatic heart disease in Melbourne, Australia from 1937 to 2013. J Paediatr Child Health. 2020;56(9):1408–1413. doi: 10.1111/jpc.14950. - DOI - PubMed
    1. Tibazarwa KB, Volmink JA, Mayosi BM. Incidence of acute rheumatic fever in the world: a systematic review of population-based studies. Heart. 2008;94(12):1534–1540. doi: 10.1136/hrt.2007.141309. - DOI - PubMed

LinkOut - more resources