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Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis

Background: While eradicated in other parts of the world, Rheumatic Heart Disease, nevertheless, remains one of the most common acquired heart diseases in low- to middle- income countries; in sub-Saharan Africa, there was an estimated prevalence of 10 persons per 1,000 population in 2015. In the Glo...

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Main Author: Dhodho, Munyaradzi
Other Authors: Engel, Mark
Format: Thesis
Language:Eng
Published: Department of Public Health and Family Medicine 2024
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access_status_str Open Access
author Dhodho, Munyaradzi
author2 Engel, Mark
author_browse Dhodho, Munyaradzi
Engel, Mark
author_facet Engel, Mark
Dhodho, Munyaradzi
author_sort Dhodho, Munyaradzi
collection Thesis
description Background: While eradicated in other parts of the world, Rheumatic Heart Disease, nevertheless, remains one of the most common acquired heart diseases in low- to middle- income countries; in sub-Saharan Africa, there was an estimated prevalence of 10 persons per 1,000 population in 2015. In the Global Burden of Disease estimates 1990-2015, Ethiopia was identified as having one of the highest burdens of RHD with a prevalence of 100-149 persons per 100,000 population. We therefore sought to estimate the prevalence of RHD, and clinical and post-operative outcomes, in Ethiopia. Objectives: We conducted a systematic review of the prevalence and outcomes of RHD according to a priori protocol. Data Sources: Studies included in this review were retrieved from PubMed and Web of Science. In addition, Google Scholar and approaching authors was used to complement the search. Data Extraction: Studies conducted after 2012 were included if the method of RHD diagnosis was echocardiography. A meta-analysis was done to measure the pooled prevalence and outcomes of RHD. Results: A total of nine studies were included in this review, 5 focusing on prevalence and 4 focusing on outcomes of RHD. The overall prevalence of asymptomatic echocardiographic RHD was per 21 per 1000 (95% CI, 12.27;32.03). In hospitalised patients, presentation included congestive heart failure, atrial fibrillation, and stroke. The 30-day mortality and post- operative mortality was 2.5 (95% CI, 0.00;12.81) and 32.8 (95% CI, 11.43;62.82) per 1000 respectively. The 60-day mortality and post-operative mortality was 33.5(95% CI, 0.00;111.38) and 161.7 (95% CI 125.54;201.27) per 1000 respectively. Conclusions And Relevance: The prevalence of asymptomatic RHD in Ethiopia is high while RHD in adults/children is associated with congestive heart failure, atrial fibrillation, and stroke. Mortality was high in patients with RHD-related heart failure; thus, to achieve the World Heart Federation target of a 25% reduction in the mortality due to RHD by 2025 in the under 25- year-olds might prove challenging.
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institution University of Cape Town (South Africa)
language Eng
last_indexed 2026-06-10T12:32:12.136Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2024
publishDateRange 2024
publishDateSort 2024
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publisherStr Department of Public Health and Family Medicine
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spelling oai:open.uct.ac.za:11427/39349 Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis Dhodho, Munyaradzi Engel, Mark Health Science Background: While eradicated in other parts of the world, Rheumatic Heart Disease, nevertheless, remains one of the most common acquired heart diseases in low- to middle- income countries; in sub-Saharan Africa, there was an estimated prevalence of 10 persons per 1,000 population in 2015. In the Global Burden of Disease estimates 1990-2015, Ethiopia was identified as having one of the highest burdens of RHD with a prevalence of 100-149 persons per 100,000 population. We therefore sought to estimate the prevalence of RHD, and clinical and post-operative outcomes, in Ethiopia. Objectives: We conducted a systematic review of the prevalence and outcomes of RHD according to a priori protocol. Data Sources: Studies included in this review were retrieved from PubMed and Web of Science. In addition, Google Scholar and approaching authors was used to complement the search. Data Extraction: Studies conducted after 2012 were included if the method of RHD diagnosis was echocardiography. A meta-analysis was done to measure the pooled prevalence and outcomes of RHD. Results: A total of nine studies were included in this review, 5 focusing on prevalence and 4 focusing on outcomes of RHD. The overall prevalence of asymptomatic echocardiographic RHD was per 21 per 1000 (95% CI, 12.27;32.03). In hospitalised patients, presentation included congestive heart failure, atrial fibrillation, and stroke. The 30-day mortality and post- operative mortality was 2.5 (95% CI, 0.00;12.81) and 32.8 (95% CI, 11.43;62.82) per 1000 respectively. The 60-day mortality and post-operative mortality was 33.5(95% CI, 0.00;111.38) and 161.7 (95% CI 125.54;201.27) per 1000 respectively. Conclusions And Relevance: The prevalence of asymptomatic RHD in Ethiopia is high while RHD in adults/children is associated with congestive heart failure, atrial fibrillation, and stroke. Mortality was high in patients with RHD-related heart failure; thus, to achieve the World Heart Federation target of a 25% reduction in the mortality due to RHD by 2025 in the under 25- year-olds might prove challenging. 2024-04-11T13:04:21Z 2024-04-11T13:04:21Z 2023 2024-04-08T12:01:48Z Thesis / Dissertation Masters MPH http://hdl.handle.net/11427/39349 Eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences
spellingShingle Health Science
Dhodho, Munyaradzi
Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis
thesis_degree_str Master's
title Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis
title_full Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis
title_fullStr Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis
title_full_unstemmed Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis
title_short Prevalence, and outcomes of Rheumatic Heart Disease in Ethiopia: a systematic review and meta-analysis
title_sort prevalence and outcomes of rheumatic heart disease in ethiopia a systematic review and meta analysis
topic Health Science
url http://hdl.handle.net/11427/39349
work_keys_str_mv AT dhodhomunyaradzi prevalenceandoutcomesofrheumaticheartdiseaseinethiopiaasystematicreviewandmetaanalysis