Table 2

RHD burden estimates in countries with very high 2015 human development indices, 1980–2017

Author, publication year, titleCountry (coverage)Study periodData sourceStudy populationMetricBurden estimates*
South Korea
Bae et al, 19878
The frequency distribution of cardiovascular diseases in 13 hospital admitted patients in Korea
South Korea
(facility)
1985Hospital discharge summary diagnosis data
(WHO 1977 classification
chronic RHD: ICD codes 393-398)
25 939 cardiovascular inpatients aged >15 years at 13 facilitiesRHD frequency among total cardiovascular admissions4.9% (n=1278)
males 3.8% (n=528), females 6.2% (n=750)
Seo et al, 20139
The economic burden of rheumatic heart disease in South Korea
South Korea
(national)
2008Claims data from National Health Insurance Corporation of Korea (ICD-10 codes IO1-IO9)General population, all agesRHD prevalence in the general population220.50 per 100 000
males 143.04 per 100 000 (n=34 924)
females 298.67 per 100 000 (n=72 252)
Age specific prevalence rates, both sexes:
0-19 years 10.27 per 100 000
20-59 years 168.78 per 100 000
60+years 791.07 per 100 000
Jang et al,  201410
Changes in the etiology of valvular heart disease in the rapidly aging Korean population
South Korea
(national)
2006–2011Korean National Health Insurance data (ICD-10 codes 105.0–2, 105.8, 105.9; 106.0–2, 106.8, 106.9)General populationRHD prevalence in the general populationAge adjusted cumulative prevalence:
2006: 74.4 per 100 000, 95% CI 73.4–75.4 (n=22 744)
2011: 71.8 per 100 000, 95% CI 70.8–72.8 (n=21 496)
Age specific prevalence rates per 100 000 (95% CI), both sexes, 2011:
20–44 years: 6.8 (6.6–7.1)
45–64 years: 31.9 (31.3–32.5)
65+ years: 33.0 (32.3–33.7)
Lee et al, 201511
Thirty-year trends in mortality from cardiovascular diseases in Korea
South Korea
(national)
1983–2012Cause of death data from Statistics Korea
(ICD-10 codes ARF and chronic RHD I00-IO9)
General populationCrude ARF/RHD mortality rates1983:
Males 0.3 per 100,000
Females: 0.5 per 100,000
2012:
males 0.2 per 100,000
females 0.7 per 100,000
Hong Kong
Woo et al, 198312
The changing prevalence and pattern of acute rheumatic fever and rheumatic heart disease in Hong Kong – (1968–1978)
Hong Kong
(facility)
1968–1978Admissions data from annual reports of Medical and Health Services Department of Hong Kong (ICD [1965 revision]: RHD codes 393–398)Hospital population (government + government assisted hospitals − 87% of all hospital beds in Hong Kong)RHD frequency among hospital admissionsRHD prevalence in hospital admissions
1968: 0.65%
1977: 0.51%
RHD prevalence in medical admissions
1968: 2.2%
1977: 1.5%
1968–1978Registry of all cardiac patients admitted to a paediatric unit and medical unit at two hospitalsHospital population (adult, paediatric)RHD frequency among hospital admissionsRHD prevalence in adult medical admissions
1969: 6.8%
1978: 3.4%
RHD prevalence in adult cardiac admissions
1968: 51.6%
1978: 35.9%
RHD prevalence in paediatric admissions
1973: 0.98% (ARF+RHD:2.2%)
1977: 0.67% (ARF+RHD: 1.6%)
RHD prevalence in paediatric cardiac admissions
1973: 34.9%
1977: 26.5%
(national)1972–1978Compulsory medical examination records for all freshmen entering one university7152 university students, ages 18-30RHD prevalence among university studentsAverage annual RHD prevalence ranged from 0.13% to 0.59%, average 0.31%
Woo and Vallance-Owen, 198813
Changing prevalence and pattern of cardiovascular diseases in Hong Kong. A perspective in the 1990s
Hong Kong
(facility)
1969–1985Annual reports of medical and health services department (1969–78 used ICD 8; 1979–85 used ICD 9)Hospital population (government and government-assisted hospitals – 88.9% of all hospital beds in Hong Kong)RHD frequency among hospital admissionsRHD prevalence among hospital population
1969: 5.3 per 1000
1985: 3.1 per 1000
RHD prevalence among medical admissions
1969: 21.1 per 1000
1985: 9.1 per 1000
1969–1987Registry of all cardiovascular patients admitted to a medical unit and a cardiac unit at 2 hospitalsHospital populationRHD frequency among hospital admissionsRHD prevalence among medical admissions
1969: 6.8% or 68 per 1000
1985: 3.4% or 34 per 1000
RHD prevalence among cardiovascular admissions
1969: 50.8% or 508 per 1000
1985: 8.8% or 88 per 1000
Japan
Kawakita, 198614
Rheumatic fever and rheumatic heart disease in Japan
Japan
(national)
1960–1981Death StatisticsTotal populationRHD death countsNo rates or proportions provided but dramatic decrease in absolute numbers.
(facility)1968–1981Hospital admissions dataCardiac patientsRHD frequency among cardiac admissionsData presented graphically only: reflects decreasing contribution of RHD and increasing contribution of ischemic heart disease to total cardiac admissions
(national)1958–1981Annual school survey (methods not stated)School children aged 6-15 years
1958: n=26 000
1961: n=131 377
1971: n=1 135 732
1981: n=524 999
RHD prevalence in school children1958: 4.6 per 1000
1961: 2.1 per 1000
1971: 0.27 per 1000
1981: 0.14 per 1000
(subnational - Osaka)1958-1981Annual survey of heart diseasePrimary and secondary school childrenRHD prevalence in primary and secondary school children1958: 4.6 per 1000
1961: 2.1 per 1000
1971: 0.2 per 1000
1981: 0.1 per 1000
Takahashi et al,201715
Heart disease mortality in the Life Span Study, 1950-2008
Japan
(subnational)
1950–2008Mortality data abstracted from death certificates (ICD-7 to ICD-10) and Japanese National Family Registration (koseki) systemFollow up of 86,600 Life Span Study cohort membersRHD as a percentage of total deaths223 RHD deaths of 55 654 total deaths=0.4%
RHD as a percentage of heart disease deaths223 RHD deaths of 9303 cardiac deaths = 2.4%
Takamori et al,  201716
Mortality analysis of the Life Span Study (LSS) cohort taking into account multiple causes of death indicated in death certificates
Japan
(subnational)
1950–2003Mortality data abstracted from death certificates (ICD-7 to ICD-10) and Japanese National Family Registration (koseki) systemFollow up of 86 611 Life Span Study cohort subjectsRHD as a percentage of circulatory deaths1950–1976: 173 of 9035 circulatory disease deaths (1.9%)
1977–2003: 84 of 10,017 circulatory disease deaths (0.84%).
Singapore
Sheares et al,  198117
Surgical management of rheumatic heart disease in Singapore
Singapore
(national)
1966–1977Mortality dataGeneral populationRHD mortality rate1966: 3.6 per 100,000
1977: 4.4 per 100,000
1978: Ratio ischemic heart disease to RHD deaths =1749/96=18.2
Substantial increase in ratio 1962–1978 shown graphically
Loh et al, 199418
Maternal mortality: evolving trends
Singapore
(facility)
1986-1992Maternal death data for deaths occurring in an obstetric unitReview of all maternal deaths among 26 173 deliveries during study period.RHD mortality rates among obstetric populationRHD mortality rate = 1/26 173 = 3.8 per 100 000 deliveries
  • *Where multiple estimates were reported, for temporal trends the earliest and latest data were extracted; age-specific or sex-specific estimates are presented for the most recent year.

  • ARF, acute rheumatic fever; RHD, rheumatic heart disease; ICD, International Classification of Diseases