Table 1
Trend of prevalent cases of rheumatic heart disease and age-standardized rate (ASR) per 100,000 from 1991 to 2021 by global, regions, and countries of South Asian region.
| 1991 | 2001 | 2011 | 2021 | AAPC BETWEEN 1991 AND 2021 (95% CI) | |||||
|---|---|---|---|---|---|---|---|---|---|
| NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | ||
| Prevalence | |||||||||
| Global | 32812.6 (26019–40634.8) | 606.7 (487–742.4) | 38419.8 (30508.8–47404.4) | 609.7 (487.9–745.3) | 47281.6 (37289.7–58609.1) | 653.7 (517.7–807.3) | 54785.1 (43328.4–67605.5) | 684.2 (540.4–848.9) | 0.4 (0.39–0.4) |
| By Region | |||||||||
| South Asia | 7465.1 (5848–9294.9) | 705.8 (559.5–878.5) | 9316.3 (7339.7–11663.5) | 708.9 (562.6–878.4) | 12184.2 (9448.9–15338.6) | 734.4 (574.1–916.4) | 14378.8 (11206.9–18056.9) | 732.2 (575.8–916.5) | 0.12 (0.11–0.13) |
| Southeast Asia, East Asia, and Oceania | 11026.6 (8604.5–13678.3) | 614.7 (489.1–755.4) | 10898.1 (8517.2–13373) | 540.1 (427.6–657.7) | 12411.8 (9953.3–15104.1) | 564.7 (449.7–689) | 12461 (10102.7–15051.4) | 546.9 (435.5–670.8) | –0.39 (–0.4 – –0.37) |
| Central Europe, Eastern Europe, and Central Asia | 1453.4 (1304.1–1633.7) | 319.5 (285.7–361.1) | 1446.4 (1289.9–1643.8) | 311 (274.4–355.8) | 1481.5 (1304–1700.9) | 318.1 (275.2–371.7) | 1487.7 (1296.9–1713.9) | 324.4 (275.1–384.2) | 0.05 (0.04–0.05) |
| High-income | 1277.9 (1143.7–1440.5) | 115.1 (103.1–129.1) | 1539 (1383–1713.7) | 119.9 (107.6–133.4) | 1549.5 (1439.9–1685) | 108.7 (98.7–120.6) | 1826.2 (1659.1–2016.9) | 112.3 (100.6–127) | –0.07 (–0.1 – –0.04) |
| Latin America and Caribbean | 3584.1 (2795.7–4506.6) | 906.4 (719.1–1122.6) | 4358.8 (3421.1–5491.9) | 901 (714.9–1116.2) | 5016.7 (3920.2–6244.8) | 893.5 (703.4–1107.6) | 5598 (4453.4–6924.1) | 901.8 (717.7–1115.9) | –0.02 (–0.02 – –0.01) |
| North Africa and Middle East | 1668.6 (1296.4–2077.2) | 513.5 (407.4–630.7) | 2280.4 (1772.7–2852.1) | 530.8 (420.7–652.5) | 2979.4 (2318.7–3708.5) | 542.5 (426.8–668.8) | 3508.1 (2763.1–4300.6) | 540.8 (428.6–660.4) | 0.17 (0.16–0.17) |
| Sub-Saharan Africa | 6336.8 (4870.3–7985.1) | 1358.9 (1072.6–1692.3) | 8580.7 (6566.5–10862.9) | 1369.1 (1086.1–1709.5) | 11658.5 (8989.8–14739.2) | 1401.7 (1108.4–1741.5) | 15525.2 (11847.4–19638.7) | 1404.4 (1109.4–1758.6) | 0.11 (0.11–0.11) |
| By Country | |||||||||
| India | 5756.6 (4515.4–7196.4) | 685.9 (544.3–855.3) | 6905.3 (5373.1–8618) | 669.9 (526–831.8) | 9193.4 (7112.2–11604.6) | 706.8 (550.3–882.8) | 10505.2 (8167.6–13207.3) | 690.9 (539.6–867.3) | 0.03 (0.02–0.04) |
| Pakistan | 885.9 (685.5–1109.1) | 878.2 (695–1086.4) | 1346.6 (1038.1–1709.1) | 1002.4 (789.4–1255.7) | 1705.8 (1322.4–2154.2) | 958.4 (758.6–1194.5) | 2340.9 (1835.9–2921.7) | 991 (789.8–1236) | 0.42 (0.39–0.44) |
| Bangladesh | 700.2 (556.6–880.7) | 710.5 (569–873.1) | 909 (718.4–1142.4) | 721.1 (569.6–908.1) | 1084.1 (837.6–1377) | 723.7 (566.1–910.4) | 1303.9 (1013.7–1622.5) | 755.6 (588.8–937) | 0.21 (0.2–0.21) |
| Nepal | 118.1 (91.5–149.3) | 666.9 (524.3–834.4) | 150.8 (119–190.1) | 671 (530.7–843) | 195.4 (151.3–244.4) | 712.7 (558.5–885.9) | 222.7 (173.4–283.3) | 692.5 (543.5–875.1) | 0.12 (0.1–0.13) |
| Bhutan | 4.4 (3.4–5.4) | 721.2 (566.6–890.2) | 4.6 (3.5–5.9) | 724.3 (564.6–912.4) | 5.5 (4.2–6.9) | 733.2 (573.5–912.1) | 6.1 (4.8–7.7) | 733.2 (576.9–916.4) | 0.05 (0.05–0.06) |
[i] UI: uncertainty interval, CI: confidence interval, AAPC: average annual percentage change.
Figure 1
Trend of rheumatic heart disease age-standardized rates of prevalence and deaths at global and regional level between 1991 and 2021.
Table 2
Trend of DALYs (Disability-Adjusted Life Years) of rheumatic heart disease and age-standardized rate (ASR) per 100,000 from 1991 to 2021 by global, regions, and countries of South Asian region.
| 1991 | 2001 | 2011 | 2021 | AAPC between 1991 and 2021 (95% CI) | |||||
|---|---|---|---|---|---|---|---|---|---|
| NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | ||
| DALYs (Disability-Adjusted Life Years) | |||||||||
| Global | 16305.4 (13720–19250.4) | 341.6 (287.7–403) | 15202.1 (13014–17989.2) | 265 (226.7–313.7) | 14284.9 (12356.5–17211) | 205.4 (177.6–247.8) | 13426.4 (11517–15780.2) | 162.1 (139.1–190.5) | –2.47 (–2.49 – –2.44) |
| By Region | |||||||||
| South Asia | 7314.8 (5818.2–9648.2) | 880.7 (687.3–1184) | 7956.4 (6305.5–10289.2) | 752.1 (581.9–994.7) | 8230.7 (6688.3–10644.7) | 611.5 (488.3–809.2) | 7656.5 (6440.1–9619.4) | 453.6 (380.1–580.9) | –2.22 (–2.27 – –2.17) |
| Southeast Asia, East Asia, and Oceania | 5158.6 (4340.6–5881.4) | 383.4 (324.2–438.5) | 3897.4 (3454.5–4411.3) | 236.5 (211.8–266.9) | 3016.8 (2677.1–3373) | 147.5 (131.7–164.2) | 2655.4 (2234.5–3145.5) | 106.2 (89.4–125.8) | –4.22 (–4.26 – –4.17) |
| Central Europe, Eastern Europe, and Central Asia | 952 (913–1009) | 202.7 (194.3–214.8) | 681.5 (649.6–721.5) | 138.7 (132–147.1) | 415.8 (388.6–450.5) | 81.3 (75.4–88.6) | 316.6 (284.6–356.5) | 58.8 (51.9–67.1) | –4.01 (–4.09 – –3.94) |
| High-income | 706.9 (668.1–738.9) | 60.6 (57.4–63.4) | 556.5 (516.2–592.5) | 39.7 (36.9–42.5) | 499.1 (447.5–539) | 29 (26.3–31.5) | 532.3 (471.9–583.8) | 25.8 (23–28.6) | –2.8 (–2.85 – –2.75) |
| Latin America and Caribbean | 467.8 (398.6–559) | 134.7 (117.4–156.9) | 456 (373.7–571.3) | 103.3 (86.5–126.6) | 440.2 (345.3–568.9) | 81.7 (65–104.4) | 445.4 (343.4–591.5) | 71.5 (55–95.3) | –2.1 (–2.13 – –2.05) |
| North Africa and Middle East | 698.5 (513.3–904.5) | 213.2 (154.8–274.8) | 595.9 (476.1–737.1) | 152.2 (120.7–185.4) | 543.6 (457.7–651.3) | 111.1 (94.8–132) | 511.3 (414.4–619.2) | 86.8 (71.3–104.2) | –2.94 (–2.97 – –2.91) |
| Sub-Saharan Africa | 1006.9 (805.8–1248.3) | 264.5 (213.3–320.6) | 1058.3 (847.9–1305) | 211.5 (172.4–257.6) | 1138.8 (898.9–1473.3) | 170.9 (139–213.4) | 1308.8 (984.2–1741.5) | 145.3 (114.3–186.8) | –1.98 (–1.99 – –1.97) |
| By Country | |||||||||
| India | 5868.2 (4662.4–7706.9) | 884 (688.9–1186.9) | 6318.1 (5041.4–8147) | 741.9 (582–976.3) | 6462 (5244.1–8413.1) | 602.7 (478.8–801.3) | 5745.5 (4785.7–7177.7) | 431.5 (361.6–548.6) | –2.38 (–2.42 – –2.34) |
| Pakistan | 663.2 (498.4–923.2) | 830.3 (617.7–1186.2) | 903.3 (684.1–1221.9) | 889.5 (665.3–1232.1) | 986.5 (752.6–1316.7) | 717.6 (543.6–992) | 1088.9 (830.1–1467.7) | 585 (443.3–816.9) | –1.16 (–1.19 – –1.13) |
| Bangladesh | 639.5 (452.7–968.1) | 857.9 (575.4–1329.6) | 608.4 (425.9–949.9) | 706.9 (485.3–1117.6) | 653 (472.9–1001.3) | 574.9 (414–895.3) | 688.5 (490.1–1115.2) | 457.6 (325–745.6) | –2.08 (–2.15 – –2.02) |
| Nepal | 140 (97.7–208.6) | 990.6 (666.5–1559.3) | 123.2 (84.8–182.2) | 703.1 (468.6–1088.8) | 126.3 (91.6–190.2) | 571.1 (405–876.9) | 130.8 (92.1–190.9) | 489.9 (343.9–726.5) | –2.31 (–2.34 – –2.27) |
| Bhutan | 3.9 (2.3–6.3) | 927.2 (583.5–1559.6) | 3.3 (2.3–5.6) | 699.8 (469.2–1243.9) | 3 (2–5.5) | 516.9 (339.9–1007) | 2.8 (1.8–4.9) | 401.9 (251.2–725.1) | –2.77 (–2.83 – –2.68) |
[i] UI: uncertainty interval, CI: confidence interval, AAPC: average annual percentage change.
Table 3
Trend of deaths due to rheumatic heart disease and age-standardized rate (ASR) per 100,000 from 1991 to 2021 by global, regions, and countries of South Asian region.
| 1991 | 2001 | 2011 | 2021 | AAPC between 1991 and 2021 (95% CI) | |||||
|---|---|---|---|---|---|---|---|---|---|
| NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | NUMBER × 103 (95% UI) | ASR/100,000 (95% UI) | ||
| Deaths | |||||||||
| Global | 420.6 (354.4–500.1) | 10 (8.5–11.9) | 394.8 (335.1–466) | 7.7 (6.5–9) | 381.7 (325.2–469.1) | 5.8 (5–7.2) | 373.3 (324.1–444.8) | 4.5 (3.9–5.3) | –2.66 (–2.7 – –2.63) |
| By Region | |||||||||
| South Asia | 177.9 (137.5–244) | 27.7 (21.2–38.3) | 196.9 (148.5–265) | 23.4 (17.5–32.1) | 218.6 (166.8–302.4) | 19.7 (14.8–27.7) | 215 (176.9–287.8) | 14.9 (12.2–20) | –2.07 (–2.14 – –2) |
| Southeast Asia, East Asia, and Oceania | 149 (124.8–172.1) | 14.2 (12–16.5) | 119.1 (107.3–134) | 9 (8.1–10.1) | 94.7 (85.9–103.2) | 5.4 (4.8–5.9) | 89.6 (73–111.1) | 3.6 (2.9–4.5) | –4.54 (–4.59 – –4.49) |
| Central Europe, Eastern Europe, and Central Asia | 26.9 (26–28.7) | 5.7 (5.5–6) | 19.4 (18.9–20.4) | 3.8 (3.7–4) | 12 (11.5–12.3) | 2.2 (2.1–2.2) | 9.4 (8.7–10.2) | 1.5 (1.4–1.6) | –4.25 (–4.35 – –4.15) |
| High-income | 31.2 (28.7–32.5) | 2.5 (2.3–2.7) | 27.2 (24.1–28.8) | 1.8 (1.6–1.9) | 27.1 (23–29.2) | 1.3 (1.1–1.4) | 30.2 (24.9–33.4) | 1.1 (1–1.3) | –2.62 (–2.68 – –2.56) |
| Latin America and Caribbean | 7.1 (6.8–7.6) | 2.6 (2.5–2.8) | 6.4 (6.1–6.8) | 1.8 (1.7–1.9) | 5.7 (5.4–6) | 1.2 (1.1–1.3) | 5.4 (4.7–5.8) | 0.9 (0.8–0.9) | –3.63 (–3.69 – –3.55) |
| North Africa and Middle East | 11.6 (8–15.3) | 4.9 (3.3–6.9) | 10 (7.7–12.8) | 3.4 (2.6–4.4) | 9.1 (7.8–10.7) | 2.4 (2.1–2.9) | 8.9 (7.5–10.6) | 1.9 (1.6–2.2) | –3.05 (–3.09 – –3.02) |
| Sub-Saharan Africa | 16.9 (13.1–20.8) | 6.7 (5.2–8.3) | 15.8 (12.6–19.2) | 5 (4–6) | 14.6 (12.5–17.5) | 3.7 (3.2–4.4) | 14.9 (12.6–18.2) | 2.8 (2.5–3.5) | –2.83 (–2.84 – –2.81) |
| By Country | |||||||||
| India | 142.6 (109.7–195.4) | 27.5 (21–38) | 156.3 (119.2–209.9) | 22.6 (17–30.9) | 175 (133.8–242.8) | 19.4 (14.6–27.5) | 166 (137.5–219.7) | 14.3 (11.8–19) | –2.18 (–2.26 – –2.1) |
| Pakistan | 16.6 (12.1–24.4) | 26.9 (19.4–40.1) | 21.8 (16.2–31) | 28.2 (20.8–42.2) | 22.5 (16.8–31.7) | 22.4 (16.5–32.9) | 24.2 (17.9–34.5) | 17.9 (13.1–25.8) | –1.35 (–1.38 – –1.32) |
| Bangladesh | 15.3 (10.1–23.9) | 28.2 (18.2–44.3) | 15.7 (10.5–25.1) | 26.1 (17.5–40.8) | 17.6 (12.3–28.2) | 20.6 (14.4–32.9) | 20.9 (14.1–36) | 16.3 (11.1–27.9) | –1.81 (–1.9 – –1.71) |
| Nepal | 3.3 (2.2–5.4) | 31.7 (20.4–52.5) | 3.1 (2–4.9) | 23.1 (14.4–38.1) | 3.4 (2.3–5.4) | 18.9 (12.7–31) | 3.8 (2.6–5.9) | 17 (11.5–26.8) | –2.05 (–2.07 – –2.01) |
| Bhutan | 0.1 (0.1–0.1) | 30.2 (19.2–51.2) | 0.1 (0.1–0.2) | 23.1 (14.8–43.8) | 0.1 (0.1–0.2) | 17.8 (11.3–37.2) | 0.1 (0–0.2) | 14.3 (8–27.4) | –2.48 (–2.52 – –2.44) |
[i] UI: uncertainty interval, CI: confidence interval, AAPC: average annual percentage change.
Table 4
The trend analysis of rheumatic heart disease age-standardized prevalence, DALYs, and death rate in last three decades at global and regional level.
| GLOBAL | SOUTH ASIA | SOUTHEAST ASIA, EAST ASIA, AND OCEANIA | CENTRAL EUROPE, EASTERN EUROPE, AND CENTRAL ASIA | HIGH-INCOME | LATIN AMERICA AND CARIBBEAN | NORTH AFRICA AND MIDDLE EAST | SUB-SAHARAN AFRICA | |
|---|---|---|---|---|---|---|---|---|
| Age-standardized prevalence rate: AAPC [95% CI] | ||||||||
| Full Range | 0.4 [0.39–0.4] | 0.12 [0.11–0.13] | –0.4 [–0.41 – –0.38] | 0.05 [0.04–0.05] | –0.07 [–0.1 – –0.04] | –0.02 [–0.02 – –0.01] | 0.17 [0.16–0.17] | 0.11 [0.11–0.11] |
| 1991–2001 | 0.04 [0.03–0.06] | 0.08 [0.06–0.1] | –1.3 [–1.34 – –1.25] | –0.28 [–0.3 – –0.26] | 0.37 [0.31–0.44] | –0.06 [–0.07 – –0.05] | 0.34 [0.32–0.35] | 0.07 [0.07–0.08] |
| 2002–2011 | 0.73 [0.71–0.75] | 0.33 [0.3–0.34] | 0.42 [0.39–0.46] | 0.26 [0.24–0.28] | –0.75 [–0.81 – –0.71] | –0.07 [–0.08 – –0.07] | 0.21 [0.19–0.22] | 0.23 [0.22–0.23] |
| 2012–2021 | 0.43 [0.41–0.44] | –0.09 [–0.12 – –0.06] | –0.29 [–0.33 – –0.26] | 0.26 [0.24–0.28] | 0.39 [0.3–0.46] | 0.11 [0.1–0.11] | –0.03 [–0.05 – –0.02] | 0.01 [0–0.01] |
| Age-standardized DALYs rate: AAPC [95% CI] | ||||||||
| Full Range | –2.47 [–2.49 – –2.44] | –2.22 [–2.27 – –2.17] | –4.22 [–4.26 – –4.17] | –4.01 [–4.09 – –3.94] | –2.8 [–2.85 – –2.75] | –2.1 [–2.13 – –2.05] | –2.94 [–2.97 – –2.91] | –1.98 [–1.99 – –1.97] |
| 1991–2001 | –2.52 [–2.59 – –2.43] | –1.59 [–1.7 – –1.47] | –4.71 [–4.83 – –4.55] | –3.57 [–3.72 – –3.39] | –4.04 [–4.16 – –3.92] | –2.59 [–2.68 – –2.47] | –3.3 [–3.39 – –3.23] | –2.21 [–2.24 – –2.19] |
| 2002–2011 | –2.51 [–2.56 – –2.44] | –1.88 [–1.99 – –1.71] | –4.83 [–4.94 – –4.76] | –5.32 [–5.43 – –5.12] | –3 [–3.1 – –2.88] | –2.17 [–2.3 – –2.08] | –2.96 [–3.05 – –2.88] | –2.11 [–2.14 – –2.09] |
| 2012–2021 | –2.35 [–2.39 – –2.3] | –3.06 [–3.24 – –2.94] | –3.12 [–3.24 – –3] | –3.13 [–3.37 – –2.94] | –1.19 [–1.36 – –1.03] | –1.19 [–1.3 – –1.05] | –2.53 [–2.62 – –2.42] | –1.59 [–1.62 – –1.56] |
| Age-standardized death rate: AAPC [95% CI] | ||||||||
| Full Range | –2.66 [–2.7 – –2.63] | –2.06 [–2.12 – –1.99] | –4.54 [–4.6 – –4.48] | –4.32 [–4.41 – –4.23] | –2.57 [–2.63 – –2.49] | –3.6 [–3.66 – –3.52] | –3.05 [–3.09 – –3.02] | –2.83 [–2.84 – –2.81] |
| 1991–2001 | –2.64 [–2.72 – –2.53] | –1.74 [–1.98 – –1.54] | –4.6 [–4.74 – –4.45] | –3.69 [–3.92 – –3.44] | –3.49 [–3.67 – –3.25] | –3.68 [–3.86 – –3.46] | –3.31 [–3.38 – –3.22] | –2.89 [–2.92 – –2.85] |
| 2002–2011 | –2.69 [–2.75 – –2.61] | –1.37 [–1.57 – –1.22] | –5.33 [–5.5 – –5.22] | –5.29 [–5.45 – –5.07] | –2.74 [–2.89 – –2.55] | –3.79 [–4.08 – –3.61] | –3.37 [–3.45 – –3.23] | –3 [–3.03 – –2.98] |
| 2012–2021 | –2.63 [–2.74 – –2.55] | –2.98 [–3.16 – –2.82] | –3.77 [–3.94 – –3.58] | –3.84 [–4.15 – –3.65] | –1.41 [–1.57 – –1.2] | –2.84 [–3.05 – –2.53] | –2.54 [–2.66 – –2.41] | –2.54 [–2.57 – –2.51] |
[i] AAPC: average annual percentage change, CI: confidence interval, DALYs: disability-adjusted life years.
Figure 2
The distribution of prevalence and deaths at global and regional level for the year 2021.