Li Chang, Gao Liuming, Wang Yanggan
Department of Geriatrics, General Medical Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
Medical Research Institute of Wuhan University, Wuhan, China.
Front Cardiovasc Med. 2025 Jun 26;12:1597855. doi: 10.3389/fcvm.2025.1597855. eCollection 2025.
Understanding the temporal evolutions in the burden of rheumatic heart disease (RHD) in children and youths is vital for devising effective and targeted preventative measures. Our objective was to deliver an accurate and thorough assessment of the prevalence, incidence and deaths of RHD in children and youths aged 5-19 years at global, regional, and national scales.
We utilized the analytical tools provided by the Global Burden of Disease and Injuries (GBD) 2021 to assess the impact of RHD on the population of children and youths aged 5-19 years. This analysis considered factors such as sex, age, region, and encompassed 204 countries and territories spanning the years 1990-2021.
The global age-standardized incidence rate (ASIR, per 100,000 population) of RHD in children and youths notably increased from 77.98 (95% confidence interval: 51.93, 110.15) in 1990 to 93.96 (62.05, 134) in 2021. Similarly, the age-standardized prevalence rate also significantly increased from 498.49 (340.79, 686.31) to 588.46 (396.8, 816.79), with an estimated annual percentage change (EAPC) of 0.42% (0.4%, 0.44%). In contrast, the global age-standardized mortality rate (ASDR, per 100,000 population) declined moderately from 1.23 (1.020, 19.89) in 1990 to 0.52 (0.45, 0.58) in 2021, with an EAPC of -2.71% (-2.9%, -2.53%). When analyzed by sociodemographic index (SDI), regions with low and low-middle SDI exhibited a greater RHD burden compared to those with high and high-middle SDI. Geographically, Sub-Saharan Africa and South Asia experienced a higher prevalence of RHD than other regions. Additionally, gender disparities were observed: women exhibited a greater prevalence of RHD, while men demonstrated higher mortality rates associated with the condition. These trends highlight the persistent global burden of RHD, particularly in lower-resource settings and among specific demographic groups.
The global burden of RHD among children and adolescents remained significant in 2021. The burden of RHD differs based on factors such as age, gender, SDI, region and country. RHD in children and youths is predominantly preventable, highlighting the need for increased focus on the targeted execution of efficient primary prevention strategies and the enhancement of healthcare systems that cater to young individuals.
了解儿童和青少年风湿性心脏病（RHD）负担的时间演变对于制定有效且有针对性的预防措施至关重要。我们的目标是在全球、区域和国家层面准确且全面地评估5至19岁儿童和青少年中RHD的患病率、发病率和死亡率。
我们利用《2021年全球疾病负担和伤害》（GBD 2021）提供的分析工具来评估RHD对5至19岁儿童和青少年人群的影响。该分析考虑了性别、年龄、地区等因素，涵盖了1990年至2021年期间的204个国家和地区。
儿童和青少年中RHD的全球年龄标准化发病率（ASIR，每10万人）从1990年的77.98（95%置信区间：51.93，110.15）显著增加到2021年的93.96（62.05，134）。同样，年龄标准化患病率也从498.49（340.79，686.31）显著增加到588.46（396.8，816.79），估计年变化百分比（EAPC）为0.42%（0.4%，0.44%）。相比之下，全球年龄标准化死亡率（ASDR，每10万人）从1990年的1.23（1.020，19.89）适度下降到2021年的0.52（0.45，0.58），EAPC为-2.71%（-2.9%，-2.53%）。按社会人口指数（SDI）分析时，低和中低SDI地区的RHD负担比高和中高SDI地区更大。在地理上，撒哈拉以南非洲和南亚的RHD患病率高于其他地区。此外，还观察到性别差异：女性的RHD患病率更高，而男性与该疾病相关的死亡率更高。这些趋势凸显了RHD在全球持续存在的负担，特别是在资源匮乏地区和特定人口群体中。
2021年，全球儿童和青少年中的RHD负担仍然很大
