Australian Institute of Health and Welfare (2021) Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019, AIHW, Australian Government, accessed 28 November 2021
Australian Institute of Health and Welfare. (2021). Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019. Retrieved from https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/acute-rheumatic-fever-and-rheumatic-heart-disease
Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019. Australian Institute of Health and Welfare, 16 July 2021, https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/acute-rheumatic-fever-and-rheumatic-heart-disease
Australian Institute of Health and Welfare. Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019 [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Nov. 28]. Available from: https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/acute-rheumatic-fever-and-rheumatic-heart-disease
Australian Institute of Health and Welfare (AIHW) 2021, Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019, viewed 28 November 2021, https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/acute-rheumatic-fever-and-rheumatic-heart-disease
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In this report, a ‘new’ rheumatic heart disease (RHD) diagnosis is defined as one that was diagnosed between 1 January 2015 and 31 December 2019. In most cases, it is not possible to identify a year of onset for RHD as the condition may be asymptomatic initially. The analysis is based on year of diagnosis.
In 2015–2019, there were 1,776 reports of new RHD diagnoses in Queensland, South Australia, Western Australia and the Northern Territory (4 per 100,000 population). Of these, 953 notifications (56%) were made in people with no previous notification of ARF.
For the four jurisdictions combined, RHD diagnosis rates between 2015 and 2019 have remained relatively stable, at around 3 to 4 diagnoses per 100,000 population annually. During this period, diagnosis rates varied by state and territory:
Data visualisation - Figure 9: New RHD diagnoses among all Australians in Qld, WA, SA and NT, by year, 2015-2019
Of the 1,776 new RHD diagnoses among all Australians in 2015–2019, 75% (1,325) were Indigenous Australians (60 per 100,000 population). The annual combined rate in Queensland, Western Australia, South Australia and the Northern Territory increased from 50 to 73 per 100,000 (213 diagnoses to 332 diagnoses) between 2015 and 2018—but decreased in 2019 to 63 per 100,000 (284 diagnoses) (Figure 9). During the same period, the overall diagnosis rate for Indigenous Australians was around 63 times the rate for non-Indigenous Australians (60 per 100,000, compared with less than 1 per 100,000, respectively).
In 2015–2019, most new RHD diagnoses among Indigenous Australians were from the Northern Territory. The rate of new diagnoses in the Northern Territory was 3 times that of Western Australia, 3 times that of Queensland and 6 times that of South Australia.
The remainder of the information on RHD in this report (with the exception of deaths) relates to Indigenous Australians, due to the relatively small number of new cases recorded among non-Indigenous Australians.
In 2015–2019, for all new RHD cases diagnosed among Indigenous Australians:
The median age at diagnosis for Indigenous Australians was 22 years (17 years for males and 24 years for females), compared with 50 years for non-Indigenous Australians.
An individual’s priority status (Box 5) determines the recommended care plan and schedule given their clinical and personal needs. This status may change over time as their condition and needs change.
Severe valvular disease or
Moderate/severe valvular lesion with symptoms or
Mechanical prosthetic valves, tissue prosthetic valves and valve repairs (including balloon valvuloplasty)
Priority 3: Mild RHD
ARF with no evidence of RHD or
Trivial to mild valvular disease
Priority 4: Inactive
Patients with a history of ARF (no RHD) for whom secondary prophylaxis has been ceased
Source: Adapted From the Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease, 2012.
In 2015–2019, of the 1,319 Indigenous Australians with new RHD diagnoses:
This distribution was similar across states and territories, with the exception of South Australia with 9% of cases being severe at diagnosis. Distribution varied by age group, with relatively large proportions of severe cases in the 45 and over age group (25% of cases). There were too few cases among those aged 0–4 to draw conclusions regarding severity at diagnosis (Figure 10).
Data visualisation - Figure 10: New RHD diagnoses among Indigenous Australians, by age group (years) and severity status (priority level), 2015-2019
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