Zühlke Liesl J, Steer Andrew C
Department of Paediatrics, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; Department of Medicine, Groote Schuur Hospital Cape Town, South Africa.
Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia; Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Glob Heart. 2013 Sep;8(3):189-95. doi: 10.1016/j.gheart.2013.08.008. Epub 2013 Sep 26.
In this review, we make the case that currently available figures used to define the global burden of acute rheumatic fever and rheumatic heart disease, although crucial to control efforts, are imperfect. Data have been hindered by methodological differences between studies, by patchy coverage within countries and across regions, and by an incomplete understanding of the relationship between echocardiographic detection of asymptomatic mild disease and progression to symptomatic disease. We argue that in order to advocate effectively for patients with rheumatic heart disease now and into the future, true burden of disease estimates on local, national, and international levels are urgently required. We critically review previous burden of disease estimates and outline the issues in defining the "true" burden of rheumatic heart disease, and we propose a new model for rheumatic heart disease epidemiologic studies. This is of particular relevance in 2012 with an ever-increasing burden of cardiovascular disease globally.
在本综述中，我们认为，目前用于界定急性风湿热和风湿性心脏病全球负担的现有数据虽对防控工作至关重要，但并不完善。研究之间的方法差异、各国及各地区参差不齐的数据覆盖情况，以及对无症状轻度疾病的超声心动图检测与症状性疾病进展之间关系的不完全理解，都阻碍了数据获取。我们认为，为了有效地为当下及未来的风湿性心脏病患者提供支持，迫切需要在地方、国家和国际层面进行疾病真实负担的评估。我们批判性地回顾了以往疾病负担的评估，并概述了界定风湿性心脏病“真实”负担的相关问题，同时提出了一种用于风湿性心脏病流行病学研究的新模型。鉴于2012年全球心血管疾病负担不断加重，这一点尤为重要。
