Indigenous Australians and newly diagnosed RHD
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.
Age and sex and RHD
In 2015–2019, for all new RHD cases diagnosed among Indigenous Australians:
- the rate of new RHD diagnosis for females was nearly 2 times that for males (76 and 44 diagnoses per 100,000 population, respectively)
- females had higher rates compared to males in all age groups, excluding those aged 5–14
- 55% were aged under 25 years at diagnosis (723 people)
- 9 children were aged under 5 and 418 children were aged between 5 and 14 at the time of RHD diagnosis (Figure 9)
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.
New RHD priority at diagnosis
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.
Box 5: RHD Priority status and health state definitions
|Priority 1: Severe RHD
Severe valvular disease or
Moderate/severe valvular lesion with symptoms or
Mechanical prosthetic valves, tissue prosthetic valves and valve repairs (including balloon valvuloplasty)
|Priority 2: Moderate RHD
||Any moderate valve lesion in the absence of symptoms and with normal left ventricular function
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:
- 55% had mild RHD when first diagnosed (725 diagnoses)
- 26% had moderate RHD (347)
- 17% had severe RHD (228) (Box 5).
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).