Impact of Socio-Economic Factors on Increased Risk and Progression of Rheumatic Heart Disease in Developing Nations.

PURPOSE OF REVIEW: Rheumatic heart disease (RHD) is a global health concern especially in low-income settings. Morbidity and mortality data from the World Health Organization (WHO) and global burden studies emphasizes on the prioritization of RHD on a global platform. Genetic, environmental, and socio-economic factors determine the sustainability and progression of RHD in various populations. In developing countries, low socioeconomic status (SES) is a vast and inevitable challenge in combating RHD. Concurrence between low SES and RHD has been well documented by several studies, but there is a paucity of data to understand comprehensive interdependency of low SES and RHD. In this review, we have made an attempt to present the overall correlation between SES and increased risk of RHD by examining and highlighting the role of key components of SES in different populations throughout the world as reported in literature. RECENT FINDINGS: In the recent past, developed countries have reported success stories regarding amelioration of RHD due to improved living conditions and better access to healthcare. Whereas, in low-income settings, various socio-economic parameters such as overcrowding, illiteracy, low monthly income, maternal employment, rural dwelling, and less access to good quality healthcare are the core challenges which significantly impose an increased risk of RHD. Overall, there is significant evidence which confirms the role of SES in increased risk and progression of RHD, but vigorous and systematic studies need to be done to evaluate the cumulative effect of SES. Also, it will be helpful in dissemination of efficient primary and secondary prevention of RHD. Additionally, another aspect of this review was to assess the plausible impact of low SES on the clinical spectrum of RHD which might characterize SES as an authoritative marker for disease progression and severity.