Rheumatic Fever: time series study

Abstract

Rheumatic fever is an autoimmune inflammatory disease that occurs as a complication of streptococcal infections, being particularly prevalent in regions with unfavorable socioeconomic conditions, where it mainly affects the heart, joints, and nervous system. This study analyzes hospitalizations due to acute rheumatic fever in Brazil between January 2010 and June 2024, using data from the Hospital Information System of the Unified Health System (SIH/SUS), with a focus on regional disparities and their possible causes. The Northeast Region leads in the number of hospitalizations, with 38.11% of the cases, reflecting the influence of factors such as high population density in urban areas with deficient healthcare infrastructure and socioeconomic conditions that favor the spread of streptococcal infections, the main triggers of rheumatic fever. The Southeast Region, the second most affected, accounts for 29.67% of hospitalizations, where the combination of high population density and internal inequalities contributes to the disease's spread. The North, South, and Midwest regions show lower incidences, possibly reflecting better living conditions and access to healthcare, especially in the South and Midwest. Gender analysis reveals a slight female predominance (51.36%), suggesting the influence of biological and hormonal factors on susceptibility to chronic complications. The concentration of cases in middle-aged adults highlights the persistence of rheumatic fever throughout life, with a more significant impact on the 50 to 59 and 40 to 49 age groups. These findings emphasize the need for regionally and demographically adapted public health policies, with an emphasis on prevention, early detection, and appropriate treatment, especially in the most affected areas.