Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2024 May 1;27(5):229-238. doi: 10.34172/aim.2024.34.
Infective endocarditis (IE), a severe and economically impactful condition, lacks substantial epidemiological data in the North Africa and Middle East (NAME) region. This study focused on analyzing the trends and burden of IE in NAME from 1990 to 2019, taking into account factors like age, gender, and socio-demographic index (SDI).
The Global Burden of Disease data from 1990 to 2019 was retrieved from the Institute for Health Metrics and Evaluation (IHME) website.
Between 1990 and 2019, the age-standardized rates (ASR) for IE incidence increased by 59%, and prevalence and years lived with disability (YLDs) rose by 12% and 9%, respectively, while the ASRs for deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) saw reductions of 22%, 34%, and 34% in the NAME region. Death rates among children under five declined by 72%. Gender and the SDI did not significantly influence these changes. Saudi Arabia witnessed the most significant increase in ASR of IE incidence since 1990, while Turkey had the highest rates in 2019. The year 2019 also saw the highest death rate among those aged 70 and over, with over 91000 DALYs from IE. DALYs decreased by 71.5% for children under five from 1990 to 2019 but remained stable for individuals in their seventies. Jordan showed the most notable decrease in ASRs for deaths, DALYs, and YLLs among children under five.
This study highlights the changing epidemiology of IE in the NAME region, recommending the establishment of multidisciplinary IE registries, antibiotic prophylaxis guidelines for healthcare-associated IE, and strategies to control antimicrobial resistance as key mitigation measures.
感染性心内膜炎（IE）是一种严重且对经济有重大影响的疾病，但在北非和中东（NAME）地区缺乏大量的流行病学数据。本研究旨在分析 1990 年至 2019 年期间 NAME 地区 IE 的趋势和负担，同时考虑年龄、性别和社会人口指数（SDI）等因素。
从 Institute for Health Metrics and Evaluation（IHME）网站获取 1990 年至 2019 年全球疾病负担数据。
1990 年至 2019 年间，IE 发病率的年龄标准化率（ASR）上升了 59%，患病率和残疾调整生命年（YLDs）分别上升了 12%和 9%，而死亡率、残疾调整生命年（DALYs）和生命损失年（YLLs）的年龄标准化率则分别下降了 22%、34%和 34%。五岁以下儿童的死亡率下降了 72%。性别和 SDI 对这些变化没有显著影响。沙特阿拉伯自 1990 年以来，IE 发病率的 ASR 增长幅度最大，而 2019 年土耳其的发病率最高。2019 年，70 岁及以上人群的死亡率最高，IE 导致的 DALYs 超过 91000。从 1990 年到 2019 年，五岁以下儿童的 DALYs 下降了 71.5%，但 70 岁以上人群的 DALYs 保持稳定。约旦在五岁以下儿童的死亡率、DALYs 和 YLLs 的 ASR 下降方面最为显著。
本研究强调了 NAME 地区 IE 流行病学的变化，建议建立多学科 IE 登记处、制定针对医疗相关 IE 的抗生素预防指南以及控制抗菌药物耐药性的策略，作为关键的缓解措施。
