Rheumatic Heart Disease in a developing country: incidence and trend (Monastir; Tunisia: 2000-2013)

Abstract Background The penicillin therapy of β hemolytic streptococcal pharyngitis has aided in the decrease of Rheumatic Heart Disease (RHD) in developing countries. Tunisia is an endemic area however, and incidence of RHD is weakly documented. We aimed at establishing the standardized incidence r...

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Bibliographic Details
Published in:International journal of cardiology 2017-02, Vol.228, p.628-632
Main Authors: Belguith, Asma Sriha, Abdelkafi, Afifa Koubaa, El Mhamdi, Sana, fredj, Manel ben, Abroug, Hela, Salah, Arwa Ben, Bouanene, Inès, Hassine, Fahima, Amara, Amal, Bhiri, Sana, Derbel, Abdelkarim, Gamra, Habib, Maatouk, Faouzi, Soltani, Mohamed Soussi
Format: Article
Language:English
Subjects:
Adult
Age
Age Factors
Aged
Cardiovascular
Developing Countries
Female
Gender
Hospital
Hospitalization - trends
Humans
Incidence
Inpatients
Male
Middle Aged
Prevalence
Registries
Retrospective Studies
Rheumatic heart disease
Rheumatic Heart Disease - epidemiology
Sex Factors
Trend
Tunisia - epidemiology
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Summary:Abstract Background The penicillin therapy of β hemolytic streptococcal pharyngitis has aided in the decrease of Rheumatic Heart Disease (RHD) in developing countries. Tunisia is an endemic area however, and incidence of RHD is weakly documented. We aimed at establishing the standardized incidence rate (SIR) of RHD in Monastir governorate, and determining RHD prevalence among hospitalized patients in two cardiology departments. Methods From the regional register of Monastir Hospital morbidity, we have selected newly diagnosed patients with RHD, residents of Monastir, and hospitalized to the 2 cardiology departments between 2000 to 2013 (2001 not included). Findings We studied 676 newly admitted patients. We estimate 1060 to be the number of new annual RHD cases in Tunisia. The SIR per 105 person-years was 10.97, being 9.3 in men and 19.1 in women respectively. We have notified a negative trend of crude incidence rate/105 Inhabitants (Inh) (CIR) (r = - 0.23, p < 10-3 ), and a strong positive correlation between age and CIR/105 Inh (r = 0.989, p < 10-4 ). RHD lethality was 1%. We have registered 728 hospitalizations for RHD, representing 2.5% of all cardiology hospitalizations [95% CI: 2.3-2.7%], with a prevalence for 13.3% for women aged 15 to 29 years. The median hospital stay was 9 days (IQR: 5-15). Conclusion Our results confirm the RHD incidence decrease, consistent with epidemiological transition in Tunisia. We have also emphasized on the close trend of RHD with age and the predominance of RHD among women especially at the procreation age.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2016.11.249