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

Abstract

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.

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