ARF recurrences

First known and recurrent acute rheumatic fever (ARF) episodes are preventable (Box 4). After the first known ARF episode, adherence to secondary prophylaxis reduces the likelihood of recurrence.

Among Aboriginal and Torres Strait Islander people in 2014–2018, 512 ARF episodes were recorded as recurrent disease (26%). First known ARF episodes increased from 222 diagnoses in 2014 to 338 in 2018—53 to 74 per 100,000 population, respectively. This is in line with an overall increase in diagnoses.

Number of ARF diagnoses among Indigenous Australians, by recurrence category. A donut graph showing the number of ARF diagnoses among Indigenous Australians by recurrence category with the option to filter by year. From 2014 to 2018, around 3 in 4 ARF diagnoses were first known diagnoses and around 1 in 4 were recurrences.

Visualisation not available for printing

Box 4: ARF episode category definitions

  • First known episode: A reported ARF episode (definite, probable or possible) in an individual with no known past ARF or RHD.
  • Recurrent episode: A reported ARF episode (definite, probable or possible) in an individual with known past ARF or RHD.

Of the 512 recurrent episodes diagnosed in 2014–2018:

  • 62% were in females. Females were more likely to have recurrent episodes, with 29% (316) of all episodes in females being recurrent, compared to 22% (196) in males.
  • among males, the greatest number of recurrences was reported in those aged 5–14
  • among females, the greatest number of recurrences was reported in those aged 25–44.

ARF recurrence rates

The measure of ARF recurrences per 100 patient-years is used to account for the different amounts of time people who have had an ARF episode are at risk of having a recurrent episode. It enables comparison of the total number of days after the first ARF episode a person is at risk of recurrence.
This analysis only includes people who were prescribed secondary prophylaxis in 2018.

In 2018:

  • among more than 3,911 people who were prescribed BPG, there were 111 reported ARF recurrences.
  • for every 100 patient-years at risk, there were 3.1 ARF recurrences.
  • most recurrences were in the NT (72 recurrences)
  • the rate of ARF recurrences per 100 patient-years was highest in the Northern Territory (4.3) and lowest in Queensland (1.7)
  • the rate of recurrence per 100 patient-years generally decreased with age, with the highest risk among those aged 0–14 (4.9).

ARF recurrences per 100 patient-years. A vertical bar chart showing the rate of ARF recurrences per 100 patient-years among all Australians in 2018. There is the option to filter by state and territory, Indigenous status, age group and sex. The highest rates of ARF recurrences were seen in the Northern Territory (4.3), among Indigenous Australians (3.3), those aged 0-14 years (4.9) and among males (3.2).

Visualisation not available for printing