Acute Rheumatic Fever: Prevalence and Epidemiology, Comparative study between Asia and Europe

Acute Rheumatic Fever (ARF) remains a significant public health concern worldwide, particularly in regions with limited healthcare access. Although incidence has markedly declined in developed countries, ARF continues to be prevalent in many low- and middle-income countries (LMICs), especially in parts of Asia. In contrast, Europe has witnessed a substantial decline in ARF cases over recent decades due to widespread antibiotic use and improved socio-economic conditions. This review aims to provide a comprehensive comparative analysis of the epidemiology of ARF in Asia and Europe, focusing on incidence rates, demographic distribution, risk factors, surveillance systems, and public health strategies. Peer-reviewed studies, regional epidemiological surveys, and World Health Organization (WHO) reports were reviewed to assess ARF patterns in different regions of Asia and Europe. Emphasis was placed on population-based data from the past 20 years, with particular attention to age groups, socio-economic factors, urban versus rural disparities, and streptococcal infection prevalence. The burden of ARF remains significantly higher in Asian countries such as India, Nepal, and Indonesia, where incidence rates range from 2 to 10 per 1,000 school-aged children. This contrasts starkly with Europe, where the incidence has declined to below 0.1 per 1,000 in most countries. Differences are primarily attributable to disparities in healthcare access, socioeconomic conditions, early detection, and treatment of streptococcal pharyngitis. Eastern and southeastern Europe still report sporadic outbreaks, especially among underprivileged populations and recent migrants.