Poster Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

Rheumatic heart disease in the Western Pacific region (#218)

Marian Abouzeid 1 , Judith Katzenellenbogen 1 2 , David Watkins 3 4 , Timothy D Johnson 1 , Jonathan Carapetis 1 5
  1. Telethon Kids Institute, University of Western Australia, Perth
  2. School of Population and Global health, University of Western Australia, Perth, WA, Australia
  3. University of Cape Town, Cape Town
  4. Department of Medicine, University of Washington, Washington
  5. Princess Margaret Hospital for Children, Western Australia


Some of the highest recorded rheumatic heart disease (RHD) prevalence and mortality rates are from the Western Pacific Region (WPR) of the World Health Organization (WHO). This region comprises approximately 1.8 billion people, across 37 developmentally diverse countries and areas.


While RHD burden is well documented in much of the WPR sub-region of Oceania, RHD in the WPR nations outside Oceania has received relatively less attention. Understanding contemporary disease burden and identifying data gaps is crucial to guide policy and programmatic action and inform research priorities.



This review narratively synthesises existing RHD burden information for the 13 WHO WPR Member States and areas outside Oceania, and Taiwan. Multiple data sources are used: English-language peer-reviewed literature, official government health statistics, modelled estimates from the Global Burden of Disease study and WHO’s Global Health Estimates database.



Over 40 publications documenting ARF/RHD burden and fulfilling inclusion criteria were identified; the majority were from China. Methods and estimates of disease burden varied considerably, between countries and over time. Some countries have no contemporary primary data publically available, and modelled estimates are used to approximate disease burden.



RHD morbidity and mortality appear to have fallen in association with economic development in some countries. In others, particularly poorer countries of the WPR, the impact of RHD appears to continue unabated. This review highlights considerable data gaps – in some countries, insufficient contemporary data makes it difficult to gauge the current status of RHD burden and control.