Australian Institute of Health and Welfare (2022) New South Wales: ARF and RHD facts, AIHW, Australian Government, accessed 26 September 2022.
Australian Institute of Health and Welfare. (2022). New South Wales: ARF and RHD facts. Retrieved from https://www.aihw.gov.au/reports/indigenous-australians/nsw-arf-rhd
New South Wales: ARF and RHD facts. Australian Institute of Health and Welfare, 17 August 2022, https://www.aihw.gov.au/reports/indigenous-australians/nsw-arf-rhd
Australian Institute of Health and Welfare. New South Wales: ARF and RHD facts [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 Sep. 26]. Available from: https://www.aihw.gov.au/reports/indigenous-australians/nsw-arf-rhd
Australian Institute of Health and Welfare (AIHW) 2022, New South Wales: ARF and RHD facts, viewed 26 September 2022, https://www.aihw.gov.au/reports/indigenous-australians/nsw-arf-rhd
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Acute rheumatic fever
Rheumatic heart disease
In New South Wales, acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are not common but are important public health issues as they cause serious illness and are preventable diseases. ARF and RHD disproportionately affect Aboriginal and Torres Strait Islander people, migrant communities, certain ethnic groups such as Māori or Pacific Islander people, and mainly impact children and young adults in NSW (NSW Health, 2018).
Although an RHD control program and register operates in New South Wales, this program is not currently covered under the Rheumatic Fever Strategy. The NSW register was established by the NSW Government in 2016, with ARF and RHD becoming notifiable in NSW in 2015. In NSW, RHD is notifiable only in persons aged under 35. This age group was targeted for prevention of worsening cardiac disease with secondary prophylaxis. As such, NSW data for RHD are not representative of the true burden of RHD in NSW (NSW RHD Program, unpublished).
For New South Wales, patients prescribed or administered secondary prophylaxis are only on the register if they have consented to being included.
At 31 December 2020, there were 163 people living with a diagnosis of ARF and/or RHD in New South Wales, representing 1.8% of the total 9,158 people recorded across all 5 jurisdictional registers. Of these 163 people in New South Wales, 65 people (40%) had only ARF recorded on the register, 64 people (39%) had only RHD recorded and 34 people (21%) had both ARF and RHD recorded (Supplementary Overview Table 1).
Unlike the other states and territories, New South Wales does not capture regional data and should be considered as a whole.
In 2016–2020 in New South Wales:
Figure 3.1: ARF notifications among all Australians in New South Wales, by year, 2016–2020. There were no clear annual trend.
Figure 3.2: ARF notifications among all Australians in New South Wales, by sex and age group, 2016–2020. The highest rate is among those 5-14 years old among both sexes. Among those 15 and over, males have a higher rate than females.
Figure 3.3: ARF notifications among Indigenous Australians in New South Wales, by year, 2016–2020. There was no clear annual trend.
Figure 3.4: ARF notifications among Indigenous Australians in New South Wales, by sex or age, 2016–2020. Children had a higher rate of ARF infections than adults. Males and females had equal rates.
In New South Wales, only RHD diagnoses in people under 35 are notifiable.
At 31 December 2020, 98 people living with RHD were recorded on the New South Wales register (Supplementary RHD Table 1).
Figure 4.1: New RHD diagnoses, all Australians in New South Wales, by year, 2016–2020. There was no clear annual trend.
Figure 4.2: New RHD diagnoses, Indigenous Australians in New South Wales, by sex or age, 2016–2020. Adults had 1.5 times the rate of new RHD diagnoses than children. Males had 1.5 times the rate of new RHD diagnoses than females.
RHD occurs only in someone who has had ARF, but some people with RHD have no recorded previous ARF episode on state and territory registers. ARF might not be notified to a register for various reasons, such as being diagnosed before the relevant register began; being diagnosed prior to the condition being notifiable; the person being in a jurisdiction that does not have a register; or the episode never being diagnosed.
Among Indigenous Australians in New South Wales with a new RHD diagnosis in 2016–2020, 13 (87%) did not have a previous ARF episode recorded on the registers, noting that any ARF diagnoses prior to 2015 are not included on the register. There were too few cases to identify patterns with sex, age, or year (Supplementary RHD Table 5).
In 2016–2020 in New South Wales, 12 people underwent 16 RHD surgical events. Due to small numbers, further analysis by Indigenous status could not be published (Supplementary RHD Table 6).
In 2020, 30 Indigenous Australians were prescribed a treatment regimen to prevent recurrences of ARF, and progression to RHD, involving regular intramuscular injections of BPG every 21 or 28 days and consented to inclusion on the register (Supplementary Secondary Prophylaxis Table 1). 30% (9 people) received at least 1 dose recorded in the register (Supplementary Secondary Prophylaxis Table 2).
In 2020, among 30 Indigenous Australians who were prescribed BPG, there were fewer than 5 reported ARF recurrences.
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