Incidence of acute rheumatic fever in the world: a systematic review of population-based studies.
BACKGROUND
There is no systematic overview of prospective studies of incidence of acute rheumatic fever (ARF) in the world.


OBJECTIVE
To summarise all population-based studies of the incidence of ARF world wide.


METHODS
A systematic review of prospective population-based studies of the overall mean and annual specific incidence of the first episode of ARF was carried out.


RESULTS
A systematic literature search identified 10 eligible studies from 10 countries on all continents, except Africa. The overall mean incidence rate of first attack of ARF was 5-51/100,000 population (mean 19/100,000; 95% CI 9 to 30/100,000). A low incidence rate of <or=10/100,000 per year was found in America and Western Europe, while a higher incidence (>10/100,000) was documented in Eastern Europe, Middle East (highest), Asia and Australasia. Studies with longitudinal data displayed a falling incidence rate over time.


CONCLUSIONS
Despite an apparent fall in incidence over time, ARF incidence rates remain relatively high in non-Western countries. No information is available for Africa.
Tibazarwa
K B
KB
Department of Medicine, J Floor Old Main Building, Groote Schuur Hospital, Cape Town, South Africa. bongani.mayosi@uct.ac.za
Volmink
J A
JA
Mayosi
B M
BM
D000208:Acute Disease; D017281:Cost of Illness; D004812:Epidemiologic Methods; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012213:Rheumatic Fever / Q000453:epidemiology*