SynthesisFrontiers in cardiovascular medicine2025
Global prevalence and sex differences in rheumatic heart disease: a systematic review and updated meta-analysis.
Synthesis in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Electrocardiographic Digital Biomarkers in Asymptomatic Schoolchildren with Rheumatic Heart Disease.Pediatric cardiology · 2026Article
- An echocardiographic appreciation of rheumatic heart disease: phenotypic variability of valvular involvement and its prognostic implications.Lancet regional health. Americas · 2026Review
- Acute rheumatic fever and rheumatic heart disease in Latin America: a contemporary review of epidemiology.Lancet regional health. Americas · 2026Review
- Inflammatory and hormonal crosstalk linking rheumatic fever to chronic valvular heart disease.Molecular biology reports · 2026Review
- Clinical characteristics and predictors of adverse outcomes in children with acute rheumatic fever from a high-endemic region of Brazil.Frontiers in cardiovascular medicine · 2026Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Rheumatic heart disease (RHD), a sequela of acute rheumatic fever (ARF), remains as the leading cause of acquired cardiac disease in children, posing a significant burden to health systems, especially in low-to-middle-income countries. While ARF shows equal prevalence among sexes in children, clinically manifest RHD in adulthood is strikingly more prevalent in females, with at least a 2:1 ratio. We conducted a meta-analysis to evaluate the global prevalence of RHD and sex disparities alongside risk factors. Methods: PubMed, Embase, Cochrane, and Lilacs were searched for cross-sectional studies on RHD prevalence in individuals aged 5-20, evaluated through echocardiogram-based screening in endemic areas. Studies relying on auscultation were excluded. RHD was defined as borderline/definite by 2012 WHF criteria or possible/probable/definite by WHO criteria. Results: Fifty-eight studies with 215,552 subjects were included. Echo-detected RHD prevalence was 24/1,000 (95%-CI: 20-30) globally. Subgroup analyses showed consistently lower RHD prevalence in males (RR: 0.70; 95%-CI: 0.61-0.80; Conclusion: This meta-analysis highlights early gender disparities in RHD, with female predominance preceding established valve lesions. Prevalence remains higher in rural areas, public schools, and low-income families, with global prevalence in endemic regions at 24/1,000. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023491941, PROSPERO CRD42023491941.
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