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Epidemiological study of pediatric rheumatic heart disease: An analysis from the Global Burden of Disease Study 2019
Chenhan Mao1, Xuemei Sun2, Dan Long3
1Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
Insights
Rheumatic heart disease (RHD) in children increased globally from 1990-2019, but mortality and disability-adjusted life years (DALYs) decreased. Lower socioeconomic development correlates with higher RHD burden, necessitating targeted interventions for children aged 10-14 and girls.
Area of Science:
- Pediatric Cardiology
- Epidemiology
- Global Health
Background:
- Rheumatic heart disease (RHD) is the leading acquired heart condition in children in developing nations.
- Systematic epidemiological studies on pediatric RHD are scarce.
- This study addresses the global, regional, and national burden of pediatric RHD from 1990-2019.
Purpose of the Study:
- To quantify the global burden of pediatric Rheumatic Heart Disease (RHD).
- To analyze epidemiological trends of childhood RHD between 1990 and 2019.
- To provide data for policymakers regarding RHD prevention and management.
Main Methods:
- Analysis of incidence, prevalence, mortality, and DALYs for childhood RHD using Global Burden of Disease Study 2019 (GBD 2019) data.
- Age-standardized rates (ASRs) were calculated and analyzed.
- Joinpoint regression analysis assessed temporal trends in RHD burden.
Main Results:
- Global RHD incidence and prevalence in children rose by over 40% from 1990-2019, with increasing age-standardized rates.
- Age-standardized DALY and mortality rates significantly decreased during the same period.
- RHD burden was higher in girls and the 10-14 year age group, and negatively associated with sociodemographic index (SDI).
Conclusions:
- Despite rising incidence and prevalence, childhood RHD mortality and DALYs declined globally between 1990-2019.
- Lower sociodemographic development is linked to a higher childhood RHD burden.
- Targeted interventions are crucial for 10-14 year olds and girls to mitigate RHD impact.
Background:
Rheumatic heart disease (RHD) is the most common acquired heart disease among children in developing countries. However, there is a lack of systematic studies on the epidemiology of pediatric RHD. This study aimed to report the burden of pediatric RHD at global, regional, and national levels between 1990 and 2019, which may provide some reference for policymakers.
Methods:
The numbers and age-standardized rates (ASRs) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for childhood RHD from 1990 to 2019 were analyzed based on data obtained from the Global Burden of Disease Study 2019 (GBD 2019). In addition, Joinpoint regression analysis was used to assess temporal trends in the burden of childhood RHD.
Results:
Globally, the number of incidence and prevalence cases of RHD in children increased by 41.89% and 40.88%, respectively, from 1990 to 2019. Age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) increased with an average annual percentage change (AAPC) of 0.75% and 0.66%, respectively. In contrast, the age-standardized DALY rate and age-standardized mortality rate (ASMR) decreased significantly since 1990 by an AAPC of -3.47% and - 2.65%, respectively. Girls had a significantly higher burden of RHD than boys during the study period. At the age level, the RHD burden was significantly highest in the age group of 10-14 years. Moreover, the ASRs of incidence, prevalence, mortality, and DALYs were negatively associated with sociodemographic index (SDI). Nationally, Fiji had the most significant increase in incidence and prevalence, and Philippines had the most remarkable rise in DALYs and mortality rates.
Conclusion:
From 1990 to 2019, although the incidence and prevalence of childhood RHD increased globally, DALYs and mortality rates markedly reduced. Countries with lower levels of sociodemographic development shoulder a higher burden of childhood RHD. Children aged 10-14 years are critical populations for whom targeted measures are needed to reduce the RHD burden, while attention to girls cannot be neglected.
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