Epidemiological Characteristics of Acute Rheumatic Fever and Chronic Rheumatic Heart Disease in the Russian Federation and Moscow, 2012–2024

Relevance. Acute rheumatic fever (ARF) and chronic rheumatic heart disease (CRHD) remain important medical and social problems despite a declining prevalence in most developed countries. These conditions are late complications of group A streptococcal infection and are associated with chronic valvular heart disease, disability, and premature mortality. Current evidence indicates persistent regional disparities in disease distribution and possible underestimation of the true disease burden. Aim . To assess long-term trends in the incidence, prevalence, and mortality of ARF and CRHD in the Russian Federation and Moscow during 2012–2024 and to evaluate age-specific and territorial characteristics of disease distribution. Materials and Methods . A retrospective descriptive epidemiological study was conducted. Data were obtained from Federal Statistical Reporting Forms No. 12 and No. 14. Analyses were performed for the total population and for the following age groups: children aged 0–14 years, adolescents aged 15–17 years, adults aged ≥ 18 years, working-age population, and older-than-working-age population. Incidence, prevalence, and mortality rates per 100,000 population, average long-term rates (ALR), average annual growth rates (AAGR), and trend significance coefficients (t) were calculated. Time-series analysis was performed using the least-squares method with trend-line construction. Results. A total of 24,815 cases of acute rheumatic fever (ARF) and 110,255 newly diagnosed cases of chronic rheumatic heart disease (CRHD) were registered in the Russian Federation between 2012 and 2024. A statistically significant decline in the main epidemiological indicators was observed. The incidence of ARF decreased 4.3-fold, from 1.76 to 0.41 per 100,000 population (AAGR = -9.6 %; p < 0.001). The incidence of CRHD decreased 1.8-fold, from 7.31 to 4.09 per 100,000 population (AAGR = -6.2 %; p < 0.001), while the prevalence of CRHD decreased 2.0-fold, from 130.88 to 66.06 per 100,000 population (AAGR = -5.8 %; p < 0.001). Mortality from ARF decreased 9.7-fold, from 0.03 to 0.003 per 100,000 population, whereas mortality from CRHD decreased 1.8-fold, from 1.09 to 0.60 per 100,000 population. The highest ARF incidence (ALR = 5.06 per 100,000 population), CRHD incidence (ALR = 13.67 per 100,000 population), and CRHD prevalence (ALR = 194.68 per 100,000 population) were observed in the North Caucasian Federal District. The highest ARF incidence was recorded among adolescents aged 15–17 years (ALR = 3.62 per 100,000 population), whereas CRHD predominantly affected individuals older than working age, with average long-term incidence and prevalence rates of 8.27 and 210.53 per 100,000 population, respectively. In Moscow, the main epidemiological indicators of ARF and CRHD were lower than the national averages and also demonstrated statistically significant declines over the study period. Conclusion . A decrease in the incidence, prevalence, and mortality associated with ARF and CRHD was observed in the Russian Federation and Moscow during 2012–2024. However, pronounced territorial disparities and age-related differences in disease distribution persist. These findings highlight the need for further improvement of epidemiological surveillance, prevention of group A streptococcal infection and its complications, and early detection of post-streptococcal diseases.