Epidemiology, Risk Factors, Burden and Cost of Acute Rheumatic Fever and Rheumatic Heart Disease

Abstract This chapter reviews what is known about the health and economic “burden” of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) worldwide. Evidence on the epidemiology of RHD has grown substantially over the last decade, but much less is known about ARF. The majority of disease risk is conferred by environmental and social factors, including poor-quality housing and household crowding, poor nutrition, and low use of preventive health services. In 2016, RHD accounted for an estimated 300,000 deaths and 10 million disability-adjusted life-years (a summary measure of premature mortality and disability) globally, and an estimated 30 million people were living with the condition. Disease rates have declined around the world, with the residual burden of disease concentrated in low-income countries and in middle-income countries like India with large subnational health inequalities. RHD results in significant economic consequences for affected individuals and households, especially those requiring costly surgical care.