ARF recurrence rates among First Nations people who were prescribed benzathine benzylpenicillin G

Adherence to secondary prophylaxis reduces the likelihood of recurrence. Trends in the number of recurrent acute rheumatic fever (ARF) episodes among people prescribed secondary prophylaxis may be used to monitor the effectiveness of ARF and rheumatic heart disease (RHD) program implementation. Recurrence rates are calculated using the rate per 100 patient-years.

Further information on patient-years can be found in Appendix A.

ARF recurrence rates in Qld, WA, SA, and the NT

In 2022:

  • 141 ARF recurrences were reported among those prescribed BPG (3.7 recurrences per 100 patient-years)
  • most recurrences were in the Northern Territory (93 recurrences)
  • the rate of ARF recurrences per 100 patient-years was highest in the Northern Territory and lowest in Western Australia
  • the rate of recurrence per 100 patient-years fluctuated with age, with the highest risk among those aged 45–64. There were no recurrences in those under 5 or 65 and over (Figure 4.6 and Figure 4.7; Supplementary table 4.7)
  • from 2018 to 2022, the ARF recurrence rate per 100 patient-years among First Nations people prescribed BPG fluctuated between 3.7 and 4.7 (Figure 4.8; Supplementary table 4.8).

Figure 4.6: ARF Recurrences per 100 patient-years among First Nations people who have received at least one dose of BPG by state or territory, as at 31 December 2022

A bar chart showing that the recurrence rate is variable by state, with the highest in the NT, and the lowest in WA.

Source: AIHW analysis of National Rheumatic Heart Disease Data Collection.

Figure 4.7: ARF Recurrences per 100 patient-years among First Nations people who have received at least one dose of BPG by age, as at 31 December 2022

A bar chart showing that the recurrence rate is highest for First Nations people in the age category of 45-64.

AIHW analysis of National Rheumatic Heart Disease Data Collection.

Figure 4.8: ARF Recurrences per 100 patient-years among First Nations people who have received at least one dose of BPG in Qld, WA, SA, and NT, 2018 to 2022

A line chart showing the fluctuations in ARF recurrence rates for First Nations people over time.

Source: AIHW analysis of National Rheumatic Heart Disease Data Collection.

ARF recurrence rates in NSW

Secondary prophylaxis data are provided in New South Wales only if an individual consents to be included. In 2022, 44% (37) of people with ARF and/or RHD consented to being included (Supplementary table 4.6a)

In 2022, among 31 First Nations people who were currently prescribed BPG, there were no reported ARF recurrences (Supplementary table 4.7). The number of recurrences each year is too small to draw meaningful conclusions about change over time.