Science and Education Publishing American Journal of Epidemiology and Infectious Disease 1 1 2013 10 08 The Descriptive Epidemiology of Acute Rheumatic Fever and Rheumatic Heart Disease in Low and Middle-Income Countries 34 40 EN Das De Sudeep Institute of Public Health, University of Cambridge, UK Krishna Sredhar AJEID2013142 10.12691/ajeid-1-4-2 2013 09 02 2013 10 02 2013 10 08 Acute rheumatic fever (ARF) and Rheumatic heart disease (RHD) have been declining in developed nations. In low and middle-income countries, however, they continue to be a major cause of mortality and morbidity. It is estimated that RHD causes 200000-250000 premature deaths every year and is the leading cause of cardiovascular death in developing nations. This review aims to describe the background, pathogenesis and epidemiology of acute rheumatic fever and rheumatic heart disease in developing nations. The paper also highlights some of the public health measures, which can be undertaken to reduce the heavy disease burden of ARF and RHD in theses countries.