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. 2023 Dec 31;16(1):2215011.
doi: 10.1080/16549716.2023.2215011.

Rheumatic heart disease burden, trends, and inequalities in Asia, 1990-2019

Chengfu Guan  1 , Wenlin Xu  1 , Shuyi Wu  1 , Jinhua Zhang  1
Affiliations

Rheumatic heart disease burden, trends, and inequalities in Asia, 1990-2019

Chengfu Guan et al. Glob Health Action. .

Abstract

Background: Rheumatic heart disease (RHD) is a serious global public health problem.

Objectives: This study aims to characterise the regional burden, trends, and inequalities of RHD in countries and territories in the Asian Region.

Methods: The RHD disease burden was measured in terms of the numbers of cases and deaths, prevalence, disability-adjusted life years (DALYs), disability-loss healthy life years (YLDs), and years of life lost (YLLs) in 48 countries in the Asian Region. Data on RHD were extracted from the 2019 Global Burden of Disease. This study analysed changing trends in the burden between 1990 and 2019, quantified regional inequalities in mortality, and classified countries by 2019 YLLs.

Results: There were an estimated 22 246 127 cases of RHD in the Asian Region in 2019 and 249 830 deaths. The prevalence of RHD in the Asian Region in 2019 was 9% lower than the global estimate, while mortality was 41% higher. The mortality rate for RHD in the Asian Region trended downwards from 1990 to 2019, with an average annual percentage change of -3.2% (95% UI -3.3 to -3.1). From 1990 to 2019, absolute inequality in RHD-related mortality decreased in the Asian Region while relative inequality increased. Of the 48 countries studied, twelve had the highest level of RHD YLLs in 2017 and the smallest reduction in YLLs from 1990 to 2019.

Conclusion: Although the burden of RHD in the Asian Region has steadily decreased since 1990, it remains a serious public health issue requiring greater attention. In the Asian Region, inequalities in the distribution of the RHD burden remain significant, with economically deprived countries typically bearing a greater share of the load.

Keywords: Cardiology; global burden of diseases; global health; health inequalities; rheumatic heart disease.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Study flow chart.
Figure 2.
Figure 2.
Rheumatic heart disease prevalence, mortality, DALYs, YLDs, and YLLs per 100 000 population by sex at global, regional, and subregional levels, 1990–2019.
Figure 3.
Figure 3.
Age-standardized YLLs per 100 000 in 2019 and its AAPC of RHD for Asian 48 countries and territories. Age-standardized YLLs of RHD per 100 000 population from 1990 through 2019 stratified by region (A) or sex (C). Age-standardized YLLs of RHD per 100 000 population by country and territory, in 2019 (B). The relative changes in age-standardized YLLs of RHD by country and territory from 1990 through 2019 (D). RHD: rheumatic heart disease.
Figure 4.
Figure 4.
Income-related health inequality regression curves for the mortality due to rheumatic heart disease across Asia, 1990 and 2019. SII: slope index of inequality; RII: relative index of inequality.
Figure 5.
Figure 5.
Age-standardized YLLs per 100 000 in 2019 and AAPC in age-standardized YLLs per 100 000 in 1990–2019 due to rheumatic heart disease for all ages and both sexes in Asia.
See this image and copyright information in PMC

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