Research Projects

     

BEAT

Burden, Estimates And Trends of RHD

Group A Streptococcus (Strep A) infections can lead to acute rheumatic fever and, if untreated, rheumatic heart disease (RHD) - a major cause of cardiovascular morbidity and mortality in low- and middle-income countries (LMICs). RHD also contributes significantly to maternal and foetal mortality, particularly in Africa. In 2021, RHD caused an estimated 373,000 deaths and 55 million cases globally, but current estimates underrepresent maternal outcomes due to data gaps. With new Strep A vaccines under development, robust and updated RHD burden and cost estimates are vital to guide vaccine policy and introduction.

 

Objectives

The South African Medical Research Council (SAMRC) and Yale School of Public Health (YSPH) are collaborating to:

Generate updated, age-stratified estimates of RHD morbidity and mortality, including maternal deaths.

Project the RHD disease burden over the next 10 years.

Quantify maternal mortality risk associated with RHD.

Assess potential impacts of new Strep A vaccines on RHD outcomes.

Estimate the global economic burden of RHD, focusing on LMICs.

Approach & Activities

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Systematic Review

Update global evidence on RHD burden and maternal mortality, registered in PROSPERO.

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Data Acquisition

Compile published and unpublished data from registries, hospital datasets, and surveillance systems.

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Maternal Mortality Analysis

Evaluate RHD-associated maternal risk through synthesis and expert consultation.

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Statistical Modelling

Use meta-regression and Bayesian methods to generate updated country-level estimates and projections, engaging WHO for review and validation.

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Economic Modelling

Estimate direct, indirect, and maternal mortality-related costs of RHD and model potential vaccine impact under different scenarios.

 

Partnerships

The project will coordinate closely with the Strep A Burden of Disease Working Group and Strep A Vaccine Consortium (SAVAC) to ensure alignment and complementarity, focusing specifically on RHD and maternal outcomes - areas underrepresented in current analyses.

Outputs & Dissemination

Deliverables include peer-reviewed publications, WHO policy briefs, and dissemination through scientific conferences and media outreach to support vaccine policy decision-making.

Timeline (Oct 1, 2025 – Sept 30, 2028)

Year 1: Evidence synthesis, partnerships, and data harmonization.

Year 2: Data analysis, model development, and manuscript preparation.

Year 3: Future burden projections, WHO consultations, and dissemination.

Expected Impact

This work will fill critical data gaps on RHD and maternal health, strengthen evidence for Strep A vaccine value, and guide global and national health policy to reduce the burden of RHD in LMICs.

Funders

Gates Foundation, Leducq Foundation & Coefficient Giving

Sites

This project will constitute a desktop study and will focus on disease burden in LMICs, particularly in South Asia and sub-Saharan Africa.

Funder & Collaborators

   

      

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Contact Info

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