Khalifa Elmusharaf, Sébastien Poix, Emil Basil Scaria, Mariyam Saherwala, Matilda Byström, Asmus Hammerich, Abdirahman Khalif Mohamud, Hicham El Berri, Eiman Hag
{"title":"The economic burden of rheumatic heart disease in the Eastern Mediterranean Region.","authors":"Khalifa Elmusharaf, Sébastien Poix, Emil Basil Scaria, Mariyam Saherwala, Matilda Byström, Asmus Hammerich, Abdirahman Khalif Mohamud, Hicham El Berri, Eiman Hag","doi":"10.1136/bmjgh-2024-018277","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Acute rheumatic fever (ARF) is an immune response triggered by group A Streptococcus (GAS) infections, predominantly affecting children aged 5-15 years. Untreated ARF can progress to rheumatic heart disease (RHD), causing complications such as valve stenosis, heart failure and stroke. Despite preventability using antibiotics, RHD persists as a major health concern in many Eastern Mediterranean Region (EMR) countries. Beyond its health implications, RHD poses a significant economic burden on societies, emphasising the need for comprehensive solutions.</p><p><strong>Methods: </strong>An economic analysis was conducted to estimate the burden of RHD in 22 countries of the EMR using data from secondary databases and existing research. The analysis modelled the future disease burden, using a scenario of inaction and considering population growth and changes in population structure. Economic losses associated with RHD were explored through five pathways, including the (a) direct healthcare costs of preventing and treating RHD and its complications, (b) cost of premature deaths, (c) cost of absenteeism in adult patients, (d) cost of absenteeism in caregivers and (e) future productivity losses due to unfulfilled potential in children.</p><p><strong>Results: </strong>The estimated economic burden of ARF, RHD and its related complications in the EMR was US$5.8 billion in 2020, amounting to 0.20% of the combined gross domestic product. Indirect costs accounted for 78% of the burden. 192 million prevalent cases and 1.5 million deaths were expected by 2050. The burden is projected to increase to US$166 billion between 2020 and 2050.</p><p><strong>Conclusion: </strong>The disease burden of RHD is rising in the EMR, widening health inequalities and straining resources. Careful planning and resource allocation based on economic evaluations are crucial to mitigate this issue. Regional governments must implement measures to address social determinants, enhance community awareness, improve surveillance and provide accessible healthcare services to effectively tackle this challenge.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 10","pages":""},"PeriodicalIF":6.1000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506036/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjgh-2024-018277","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Acute rheumatic fever (ARF) is an immune response triggered by group A Streptococcus (GAS) infections, predominantly affecting children aged 5-15 years. Untreated ARF can progress to rheumatic heart disease (RHD), causing complications such as valve stenosis, heart failure and stroke. Despite preventability using antibiotics, RHD persists as a major health concern in many Eastern Mediterranean Region (EMR) countries. Beyond its health implications, RHD poses a significant economic burden on societies, emphasising the need for comprehensive solutions.
Methods: An economic analysis was conducted to estimate the burden of RHD in 22 countries of the EMR using data from secondary databases and existing research. The analysis modelled the future disease burden, using a scenario of inaction and considering population growth and changes in population structure. Economic losses associated with RHD were explored through five pathways, including the (a) direct healthcare costs of preventing and treating RHD and its complications, (b) cost of premature deaths, (c) cost of absenteeism in adult patients, (d) cost of absenteeism in caregivers and (e) future productivity losses due to unfulfilled potential in children.
Results: The estimated economic burden of ARF, RHD and its related complications in the EMR was US$5.8 billion in 2020, amounting to 0.20% of the combined gross domestic product. Indirect costs accounted for 78% of the burden. 192 million prevalent cases and 1.5 million deaths were expected by 2050. The burden is projected to increase to US$166 billion between 2020 and 2050.
Conclusion: The disease burden of RHD is rising in the EMR, widening health inequalities and straining resources. Careful planning and resource allocation based on economic evaluations are crucial to mitigate this issue. Regional governments must implement measures to address social determinants, enhance community awareness, improve surveillance and provide accessible healthcare services to effectively tackle this challenge.
期刊介绍：
BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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