The Economic Impact of Rheumatic Heart Disease in Low- and Middle-Income Countries

Authors: David Watkins, Angela Chang

Introduction:

Rheumatic heart disease (RHD) is an important cause of cardiovascular death and disability among children and working-age adults in low- and middle-income countries (LMICs). RHD is the consequence of untreated streptococcal pharyngitis, which in susceptible individuals leads to repeated attacks of acute rheumatic fever (ARF) that over time cause progressive heart valve damage, resulting in sequelae such as heart failure, atrial fibrillation/stroke, and premature death. The condition is highly preventable with prompt antibiotic treatment of acute pharyngitis (“primary prevention”) or regular prophylactic antibiotic use among individuals who have a history of ARF (“secondary prevention”). Surgical repair or replacement of damaged heart valves is also a last-resort option in many cases.