Bayesian Modeling to Project the National and Regional Burden of Rheumatic Heart Disease in Brazil Till 2050.

BACKGROUND

Rheumatic heart disease (RHD) remains a significant public health concern in middle- to low-income countries. Despite advancements in healthcare access and public health measures in Brazil, future projections of RHD burden are essential to guide policy-making. Thus, we projected the national and regional burden of RHD in Brazil through 2050.

METHODS

Annual prevalence counts and disability-adjusted life years (DALYs) for RHD from 2000 to 2021 were extracted from the 2021 Global Burden of Disease (GBD) dataset for 10-year age brackets (5-74 years). Age-standardized prevalence (asPR) and DALYs rates (asDALYs) per 100,000 were calculated nationally and regionally. Bayesian age-period-cohort models were used to project trends through 2050, with results reported as medians (25th, 75th percentiles) and estimated annual percentage changes (EAPCs).

RESULTS

From 2000 to 2021, Brazil's population grew by 27%. Nationally, the asPR declined slightly from 1,503 to 1,495 per 100,000 [EAPC: -0.04% (95% CI: -0.05, -0.03)], with reductions observed in most regions. However, increases were noted in the North [EAPC: 0.14% (95% CI: 0.13, 0.15)] and Northeast [EAPC: 0.02% (95% CI: 0.01, 0.03)]. Males experienced greater reductions [EAPC: -0.16% (95% CI: -0.19, -0.13)] compared to females, who showed a slight increase [EAPC: 0.05% (95% CI: 0.03, 0.07)]. Projections indicate that asPR will decline nationally to 1,418 per 100,000 by 2050 [EAPC: -0.20% (95% CI: -0.20, -0.19)], with the South and Central West regions reducing the most.The asDALY rates declined from 142 to 104 per 100,000 [EAPC: -1.58% (95% CI: -1.69, -1.46)] during 2000-2021, with all regions showing decreases, particularly the Southeast [EAPC: -1.83% (95% CI: -1.98, -1.69)]. Nationally, projections suggest further reductions to 75 per 100,000 by 2050 [EAPC: -1.17% (95% CI: -1.22, -1.11)].

CONCLUSION

The burden of RHD in Brazil has decreased nationally and regionally over recent decades. Projections suggest that these trends will continue.