Epidemiology of Rheumatic Heart Disease

Описание: Rheumatic Heart Disease (RHD) affects an estimated 55 million people globally and causes approximately 360,000 deaths each year, primarily in low- and middle-income countries. It is the most common acquired heart disease in people under age 25.

🌍 Global Burden and Distribution
Prevalence: Around 55 million people live with RHD worldwide.

Mortality: RHD causes about 360,000 deaths annually, mostly in resource-poor settings.

Age group: It is the leading cause of acquired heart disease in children and young adults, especially under age 25.

Geographic hotspots:

Sub-Saharan Africa

South Asia

Pacific Islands

Parts of Latin America

These regions face challenges like limited access to healthcare, poor living conditions, and delayed treatment of streptococcal infections.

📈 Trends Over Time
Decline in high-income countries: Due to improved living standards and widespread antibiotic use.

Persistent burden in LMICs: Despite global health efforts, RHD remains endemic in many low-resource settings.

From 1990 to 2019, age-standardized rates of RHD incidence and mortality have shown regional variability, with some areas experiencing increases due to population growth and healthcare gaps.

🧬 Pathogenesis and Risk Factors
Initial trigger: Group A streptococcal pharyngitis (strep throat)

Autoimmune response: Leads to acute rheumatic fever

Chronic damage: Repeated or severe episodes cause progressive valve scarring, especially of the mitral and aortic valves

Risk factors include:

Poverty and overcrowding

Limited access to antibiotics

Lack of awareness and early diagnosis

Genetic susceptibility

🩺 Prevention and Control
Primary prevention: Prompt antibiotic treatment of strep throat

Secondary prevention: Long-term penicillin prophylaxis after rheumatic fever

Tertiary care: Surgical valve repair or replacement in advanced cases

Public health strategies: School-based screening, health education, and improved living conditions

🧠 Summary
RHD remains a major global health challenge, especially in underserved populations. While largely preventable, it continues to cause significant morbidity and mortality due to systemic inequities in healthcare access and disease awareness

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