Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study
<b>Background</b>: Rheumatic heart disease (RHD) remains a major contributor to childhood cardiovascular morbidity and mortality globally, particularly in low-resource settings. This study offers a thorough evaluation of the global, regional, and national burden of RHD among children age...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-06-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/12/7/843 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850078091381047296 |
|---|---|
| author | Ze Tang Ziwei Wang Xinbao Wang |
| author_facet | Ze Tang Ziwei Wang Xinbao Wang |
| author_sort | Ze Tang |
| collection | DOAJ |
| description | <b>Background</b>: Rheumatic heart disease (RHD) remains a major contributor to childhood cardiovascular morbidity and mortality globally, particularly in low-resource settings. This study offers a thorough evaluation of the global, regional, and national burden of RHD among children aged 0–14 years, from 1990 to 2021, utilizing data from the 2021 Global Burden of Disease (GBD) study. <b>Methods</b>: We analyzed age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for RHD in 204 countries and territories. Novel methodological approaches included APC analysis to decompose temporal trends into age, period, and cohort effects, and inequality analysis to assess socioeconomic disparities. We calculated age-standardized rates and average annual percentage changes (AAPC) by sex, region, and socio-demographic index (SDI) level. <b>Results</b>: From 1990 to 2021, the global age-standardized death rate due to RHD in children declined by approximately 74%, from 1.24 to 0.32 per 100,000 (AAPC: −4.27%). Similarly, DALY rates dropped from 117.22 to 41.56 per 100,000 (AAPC: −3.30%). Despite this progress, the global age-standardized incidence rate increased modestly from 55.84 to 66.76 per 100,000 (AAPC: 0.58%), and prevalence rates also rose (AAPC: 0.53%). Females consistently experienced higher burden across all metrics. Inequality analysis demonstrated a concerning divergence: while mortality and DALY inequalities narrowed substantially (mortality slope index of inequality (SII) improved from −1.35 to −0.31), incidence and prevalence inequalities widened (incidence SII worsened from −112.60 to −131.90), indicating growing disparities in disease occurrence despite improved survival. <b>Conclusions</b>: While global mortality and DALYs from childhood rheumatic heart disease have declined substantially over the past three decades, a troubling paradox has emerged: rising incidence rates alongside widening socioeconomic inequalities in disease occurrence. This represents a critical public health challenge demanding targeted intervention strategies. The divergent trends in health outcomes, namely, improved survival rates but increased disease burden, reveal that while access to treatment has advanced, upstream prevention efforts remain critically inadequate among socioeconomically disadvantaged populations. |
| format | Article |
| id | doaj-art-2452e4ceb2b5409db35c8f45815e19a6 |
| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-2452e4ceb2b5409db35c8f45815e19a62025-08-20T02:45:38ZengMDPI AGChildren2227-90672025-06-0112784310.3390/children12070843Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 StudyZe Tang0Ziwei Wang1Xinbao Wang2Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China<b>Background</b>: Rheumatic heart disease (RHD) remains a major contributor to childhood cardiovascular morbidity and mortality globally, particularly in low-resource settings. This study offers a thorough evaluation of the global, regional, and national burden of RHD among children aged 0–14 years, from 1990 to 2021, utilizing data from the 2021 Global Burden of Disease (GBD) study. <b>Methods</b>: We analyzed age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for RHD in 204 countries and territories. Novel methodological approaches included APC analysis to decompose temporal trends into age, period, and cohort effects, and inequality analysis to assess socioeconomic disparities. We calculated age-standardized rates and average annual percentage changes (AAPC) by sex, region, and socio-demographic index (SDI) level. <b>Results</b>: From 1990 to 2021, the global age-standardized death rate due to RHD in children declined by approximately 74%, from 1.24 to 0.32 per 100,000 (AAPC: −4.27%). Similarly, DALY rates dropped from 117.22 to 41.56 per 100,000 (AAPC: −3.30%). Despite this progress, the global age-standardized incidence rate increased modestly from 55.84 to 66.76 per 100,000 (AAPC: 0.58%), and prevalence rates also rose (AAPC: 0.53%). Females consistently experienced higher burden across all metrics. Inequality analysis demonstrated a concerning divergence: while mortality and DALY inequalities narrowed substantially (mortality slope index of inequality (SII) improved from −1.35 to −0.31), incidence and prevalence inequalities widened (incidence SII worsened from −112.60 to −131.90), indicating growing disparities in disease occurrence despite improved survival. <b>Conclusions</b>: While global mortality and DALYs from childhood rheumatic heart disease have declined substantially over the past three decades, a troubling paradox has emerged: rising incidence rates alongside widening socioeconomic inequalities in disease occurrence. This represents a critical public health challenge demanding targeted intervention strategies. The divergent trends in health outcomes, namely, improved survival rates but increased disease burden, reveal that while access to treatment has advanced, upstream prevention efforts remain critically inadequate among socioeconomically disadvantaged populations.https://www.mdpi.com/2227-9067/12/7/843rheumatic heart diseaseGlobal Burden of Diseasechildrendisability-adjusted life years (DALYs)health inequality |
| spellingShingle | Ze Tang Ziwei Wang Xinbao Wang Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study Children rheumatic heart disease Global Burden of Disease children disability-adjusted life years (DALYs) health inequality |
| title | Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study |
| title_full | Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study |
| title_fullStr | Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study |
| title_full_unstemmed | Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study |
| title_short | Global Burden of Pediatric Rheumatic Heart Disease, 1990–2021: Analysis of the GBD 2021 Study |
| title_sort | global burden of pediatric rheumatic heart disease 1990 2021 analysis of the gbd 2021 study |
| topic | rheumatic heart disease Global Burden of Disease children disability-adjusted life years (DALYs) health inequality |
| url | https://www.mdpi.com/2227-9067/12/7/843 |
| work_keys_str_mv | AT zetang globalburdenofpediatricrheumaticheartdisease19902021analysisofthegbd2021study AT ziweiwang globalburdenofpediatricrheumaticheartdisease19902021analysisofthegbd2021study AT xinbaowang globalburdenofpediatricrheumaticheartdisease19902021analysisofthegbd2021study |