Rheumatic Heart Disease in Asia

A few years ago, my colleagues and I conducted a system-atic review of data relating to the global burden of group A streptococcal diseases.1,2 Population-based data on rheumatic heart disease prevalence from 1985 through 2002 were included. We estimated that there were a minimum of 15.6 million people in the world with rheumatic heart disease, with 282 000 new cases each year and 233 000 resultant deaths each year; how-ever, we also noted that the estimates of the number of cases in school-aged children in China (176 500) and Asia Other (102 000; Asia excluding South-Central Asia and China) were based on very few studies, none of which used echocardiography to confirm the presence of rheumatic heart disease lesions. Moreover, 5 of the 6 studies included in the Asia Other estimate came from 1 country, the Philippines. We therefore urged caution in interpreting these data from Asia, other than South-Central Asia, and concluded that there was an urgent need for