Table 3.
Evolution of clinically silent rheumatic heart disease (RHD).
| RHD definition | N Studies | N Participants | Prevalence, per 1000 (95%CI) | Prediction interval | I² (95%CI) | H (95%CI) | p heterogeneity | p Egger test |
|---|---|---|---|---|---|---|---|---|
| Definite RHD | ||||||||
| • Progression* | 6 | 315 | 7.5 (1.5–17.6) | 0.0–50.4 | 2.5 (1.7–3.6) | 83.5 (65.4–92.1) | < 0.0001 | 0.549 |
| • Regression** | 6 | 315 | 24.6 (14.9–35.9) | 1.9–61.2 | 1.9 (1.3–2.9) | 72.8 (37.5–88.2) | 0.0025 | 0.489 |
| • Stable (persistence)*** | 6 | 315 | 60.7 (42.4–77.5) | 7.0–99.7 | 2.9 (2.1–4.1) | 88.4 (77.4–94.1) | < 0.0001 | 0.643 |
| Borderline RHD | ||||||||
| • Progression§ | 7 | 377 | 11.3 (6.9–16.5) | 2.0–26.8 | 1.4 (1.0–2.1) | 46.6 (0.0–77.5) | 0.0811 | 0.608 |
| • Regression§§ | 6 | 322 | 39.1 (28.8–49.9) | 11.0–72.0 | 1.7 (1.1–2.7) | 67.4 (22.7–86.3) | 0.0089 | 0.233 |
| • Stable (persistence)§§§ | 6 | 322 | 48.6 (36.7–60.6) | 14.1–84.0 | 1.9 (1.3–2.9) | 73.5 (39.4–88.4) | 0.0020 | 0.562 |
| Nonspecific valvular abnormalities (NSVA) | ||||||||
| • Progression& | 3 | 126 | 8.7 (4.4–14.2) | 0.0–57.9 | 1.0 (1.0–1.2) | 0.0 (0.0–26.4) | 0.868 | 0.729 |
| • Stable (persistence)&& | 2 | 64 | 92.2 (84.5–97.5) | NA | 1.0 | 0.0 | 0.710 | NA |
*Progression of definite RHD = Number of cases of definite RHD which progressed to clinically manifest RHD/Number of definite RHD cases at the onset of follow up; **Regression of definite RHD = Number of cases of definite RHD which converted to borderline RHD/Number of definite RHD cases at the onset of follow up; ***Stable definite RHD = Number of cases of definite RHD which remained stable during follow up/Number of definite RHD cases at the onset of follow up.
§Progression of borderline RHD = Number of cases of borderline RHD which progressed to definite RHD/Number of borderline RHD cases at the onset of follow up; §§Regression of borderline RHD = Number of cases of borderline RHD which converted to normal/Number of borderline RHD cases at the onset of follow up; §§§Stable borderline RHD = Number of cases of borderline RHD which remained stable during follow-up/Number of definite RHD cases at the onset of follow up.
&Progression NSVA = Number of normal cases which developed borderline or definite RHD/Number of normal cases at the onset of follow up; &&Stable NSVA = Number of cases diagnosed as normal which remained normal after follow up (Stable normal)/Number of normal cases at the onset of follow up.
NA = not applicable; CI = confidence interval.