title: Incidence of acute rheumatic fever in the world: a systematic review of population-based studies.
abstract: 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.
authors.affiliation: Department of Medicine, J Floor Old Main Building, Groote Schuur Hospital, Cape Town, South Africa. bongani.mayosi@uct.ac.za
authors.forename: K B
authors.initials: KB
authors.lastname: Tibazarwa
authors.forename: J A
authors.initials: JA
authors.lastname: Volmink
authors.forename: B M
authors.initials: BM
authors.lastname: Mayosi
mesh_terms: 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*