The burden of rheumatic heart disease in the Middle East and North Africa region, 1990−2019

Saeid Safiri, Seyed Ehsan Mousavi, Maryam Noori, Seyed Aria Nejadghaderi, Mark J.M. Sullman, Kuljit Singh, Ali Asghar Kolahi

Research output: Contribution to journalArticlepeer-review


Background: Rheumatic heart disease (RHD) is a treatable and preventable condition resulting from acute rheumatic fever. Aim: To report the prevalence, mortality and disability-adjusted life-years (DALY) due to RHD in the Middle East and North Africa (MENA) region from 1990 to 2019, by sex, age group, country and sociodemographic index (SDI). Methods: Information on the prevalence, mortality and DALY associated with RHD were obtained from the Global Burden of Disease Study 2019. Data were gathered for all countries in the MENA region over the period 1990–2019. These data included counts and age-standardized rates per 100,000, accompanied by 95% uncertainty intervals (UIs). Results: The MENA region had an age-standardized point prevalence of 388.9 per 100,000 in 2019, which was 5.4% higher than in 1990. The annual incidence rate was 1.6, which was 63.4% lower than in 1990. There were 379.4 thousand DALY attributable to RHD in 2019, with an age-standardized rate of 67.1, which was 61.3% lower than in 1990. In 2019, an estimated 7.4 thousand deaths were due to RHD, and the age-standardized death rate was 63.4% lower in 2019 than in 1990. DALY rates rose steadily with increasing age in both males and females. The SDI correlated negatively with the rate of DALY for RHD throughout the study period. Conclusion: The burden of RHD in MENA declined from 1990 to 2019, demonstrating the importance of regularly updating health data and identifying risk factors, and developing effective guidelines on prevention.

Original languageEnglish
JournalArchives of Cardiovascular Diseases
Publication statusAccepted/In press - 2023


  • Disability-adjusted life-years
  • Epidemiology
  • Middle East and North Africa
  • Mortality
  • Rheumatic heart disease


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