GLOBAL BURDEN OF CARDIOVASCULAR DISEASE

Incidence of acute rheumatic fever in the world: a systematic review of population-based studies

K B Tibazarwa¹, J A Volmink², B M Mayosi¹

¹ Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
² Faculty of Health Sciences, Tygerberg Hospital and University of Stellenbosch, Tygerberg, South Africa

Professor B M Mayosi, Department of Medicine, J Floor Old Main Building, Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa; bongani.mayosi{at}uct.ac.za

Background: There is no systematic overview of prospective studies of incidence of acute rheumatic fever (ARF) in the world.

Aim: To summarise all population-based studies of the incidence of ARF world wide.

Method: A systematic review of prospective population-based studies of the overall mean and annual specific incidence of the first episode of ARF was carried out.

Results: A systematic literature search identified 10 eligible studies from 10 countries on all continents, except Africa. The overall mean incidence rate of first attack of ARF was 5–51/100 000 population (mean 19/100 000; 95% CI 9 to 30/100 000). A low incidence rate of 10/100 000 per year was found in America and Western Europe, while a higher incidence (>10/100 000) was documented in Eastern Europe, Middle East (highest), Asia and Australasia. Studies with longitudinal data displayed a falling incidence rate over time.

Conclusion: Despite an apparent fall in incidence over time, ARF incidence rates remain relatively high in non-Western countries. No information is available for Africa.

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