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

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
• rheumatic heart disease
• health inequalities

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Author contributions

JZ initiated the study. CG, WX, and SW performed data extraction, and analyses. CG drafted the first version of the manuscript. JZ and CG critically reviewed the manuscript and revised it. All gave final approval and agreed to be accountable for all aspects of work ensuring integrity and accuracy.

Disclosure statement

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

Paper context

Evidence of the burden of Rheumatic Heart Disease and health inequalities between countries and territories can be used to improve the allocation of health resources and reduce health disparities between countries. This paper examines the burden of Rheumatic Heart Disease and health inequalities in 48 countries and territories in the Asian Region. The findings show that Rheumatic Heart Disease remains a very serious public health problem and that significant health disparities in this Disease exist between countries.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2023.2215011.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.