Acute Rheumatic Fever and Rheumatic Heart Disease in Children Aged Less Than 5 Years in the Northern Territory...

Area of Science:

• Pediatrics
• Cardiology
• Public Health

Background:

• Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are significant public health concerns, disproportionately affecting socioeconomically disadvantaged populations globally.
• In Australia, ARF and RHD remain prevalent among Indigenous children, highlighting persistent health disparities.

Purpose of the Study:

• To describe the clinical presentation and outcomes of ARF and RHD in children under five years old in Australia's Northern Territory.
• To improve the recognition and management of ARF and RHD in this vulnerable pediatric population.

Main Methods:

• A retrospective audit of children under five diagnosed with ARF and/or RHD between 2010 and 2020 in the Northern Territory.
• Data were extracted from the NT RHD register, including demographics, clinical features, diagnosis, severity, management, and outcomes.

Main Results:

• 82 children under five were identified with ARF and/or RHD.
• Aboriginal and Torres Strait Islander children experienced disproportionately high incidences of ARF (127/100,000) and RHD (33/100,000).
• ARF recurrence was 23%, 55% of RHD cases were moderate to severe, and 20% required cardiac surgery.

Conclusions:

• Children under five in remote Northern Territory communities are at risk of ARF and RHD, with Indigenous children most affected.
• Prompt investigation of ARF symptoms like joint pain, chorea, or new murmurs is essential.
• Echocardiographic screening for RHD is recommended for children in remote NT from age three.