Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis

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dc.contributor.advisorEngel, Mark
dc.contributor.advisorZühlke, Liesl
dc.contributor.authorDhodho, Munyaradzi
dc.date.accessioned2026-04-22T07:00:08Z
dc.date.available2026-04-22T07:00:08Z
dc.date.issued2023
dc.date.updated2026-04-21T13:50:35Z
dc.description.abstractBackground: While eradicated in other parts of the world, Rheumatic Heart Disease, nevertheless, remains one of the most common acquired heart diseases in low- to middle- income countries; in sub-Saharan Africa, there was an estimated prevalence of 10 persons per 1,000 population in 2015. In the Global Burden of Disease estimates 1990-2015, Ethiopia was identified as having one of the highest burdens of RHD with a prevalence of 100-149 persons per 100,000 population. We therefore sought to estimate the prevalence of RHD, and clinical and post-operative outcomes, in Ethiopia. Objectives: We conducted a systematic review of the prevalence and outcomes of RHD according to a priori protocol. Data Sources: Studies included in this review were retrieved from PubMed and Web of Science. In addition, Google Scholar and approaching authors was used to complement the search. Data Extraction: Studies conducted after 2012 were included if the method of RHD diagnosis was echocardiography. A meta-analysis was done to measure the pooled prevalence and outcomes of RHD. Results: A total of nine studies were included in this review, 5 focusing on prevalence and 4 focusing on outcomes of RHD. The overall prevalence of asymptomatic echocardiographic RHD was per 21 per 1000 (95% CI, 12.27;32.03). In hospitalised patients, presentation included congestive heart failure, atrial fibrillation, and stroke. The 30-day mortality and post- operative mortality was 2.5 (95% CI, 0.00;12.81) and 32.8 (95% CI, 11.43;62.82) per 1000 respectively. The 60-day mortality and post-operative mortality was 33.5(95% CI, 0.00;111.38) and 161.7 (95% CI 125.54;201.27) per 1000 respectively. Conclusions And Relevance: The prevalence of asymptomatic RHD in Ethiopia is high while RHD in adults/children is associated with congestive heart failure, atrial fibrillation, and stroke. Mortality was high in patients with RHD-related heart failure; thus, to achieve the World Heart Federation target of a 25% reduction in the mortality due to RHD by 2025 in the under 25- year-olds might prove challenging.
dc.identifier.apacitationDhodho, M. (2023). <i>Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/43107en_ZA
dc.identifier.chicagocitationDhodho, Munyaradzi. <i>"Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2023. http://hdl.handle.net/11427/43107en_ZA
dc.identifier.citationDhodho, M. 2023. Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis. . University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/43107en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Dhodho, Munyaradzi AB - Background: While eradicated in other parts of the world, Rheumatic Heart Disease, nevertheless, remains one of the most common acquired heart diseases in low- to middle- income countries; in sub-Saharan Africa, there was an estimated prevalence of 10 persons per 1,000 population in 2015. In the Global Burden of Disease estimates 1990-2015, Ethiopia was identified as having one of the highest burdens of RHD with a prevalence of 100-149 persons per 100,000 population. We therefore sought to estimate the prevalence of RHD, and clinical and post-operative outcomes, in Ethiopia. Objectives: We conducted a systematic review of the prevalence and outcomes of RHD according to a priori protocol. Data Sources: Studies included in this review were retrieved from PubMed and Web of Science. In addition, Google Scholar and approaching authors was used to complement the search. Data Extraction: Studies conducted after 2012 were included if the method of RHD diagnosis was echocardiography. A meta-analysis was done to measure the pooled prevalence and outcomes of RHD. Results: A total of nine studies were included in this review, 5 focusing on prevalence and 4 focusing on outcomes of RHD. The overall prevalence of asymptomatic echocardiographic RHD was per 21 per 1000 (95% CI, 12.27;32.03). In hospitalised patients, presentation included congestive heart failure, atrial fibrillation, and stroke. The 30-day mortality and post- operative mortality was 2.5 (95% CI, 0.00;12.81) and 32.8 (95% CI, 11.43;62.82) per 1000 respectively. The 60-day mortality and post-operative mortality was 33.5(95% CI, 0.00;111.38) and 161.7 (95% CI 125.54;201.27) per 1000 respectively. Conclusions And Relevance: The prevalence of asymptomatic RHD in Ethiopia is high while RHD in adults/children is associated with congestive heart failure, atrial fibrillation, and stroke. Mortality was high in patients with RHD-related heart failure; thus, to achieve the World Heart Federation target of a 25% reduction in the mortality due to RHD by 2025 in the under 25- year-olds might prove challenging. DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Medicine KW - Heart Disease KW - Ethiopia LK - https://open.uct.ac.za PB - University of Cape Town PY - 2023 T1 - Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis TI - Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis UR - http://hdl.handle.net/11427/43107 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43107
dc.identifier.vancouvercitationDhodho M. Prevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43107en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectMedicine
dc.subjectHeart Disease
dc.subjectEthiopia
dc.titlePrevalence, and outcomes of rheumatic heart disease in ethiopia: a systematic review and meta-analysis
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMasters
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