Related Experiment Video
Updated: Jan 18, 2026
Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding
Published on: August 30, 2024
Acute Rheumatic Fever and Rheumatic Heart Disease in Children Aged Less Than 5 Years in the Northern Territory
Z Stephenson1, B Jones1,2, B Remenyi1,2
1Paediatric Department, Royal Darwin Hospital, Casuarina, Australia.
Insights
Young Australian children, particularly Aboriginal and Torres Strait Islander children, face high risks of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Early recognition and echocardiographic screening are crucial for managing these preventable conditions in remote areas.
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.
Aim:
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are preventable diseases affecting socioeconomically disadvantaged populations globally, including Australian children. This study aims to describe the clinical presentation and outcomes of ARF and RHD in children aged less than 5 years, to improve recognition and management.
Method:
A retrospective audit was undertaken of children aged less than 5 years with ARF and RHD in the Northern Territory (NT) of Australia between 2010 and 2020. Patients were identified from the NT RHD register. Descriptive data analyses were performed to summarise patient demographics, clinical presentation, diagnosis, disease severity, management, and outcomes.
Results:
During the study period, 82 children (51% female) aged less than 5 years presented with definite, probable, or possible ARF (78/82), and/or RHD (20/82). Aboriginal and Torres Strait Islander children were disproportionately affected, with average annual incidences (2010-2020) of ARF and RHD of 127 (95% confidence interval [CI]: 99-155) and 33 (95% CI: 18-47) per 100,000 population, respectively. ARF recurrence was common (23%). At diagnosis, RHD was moderate to severe in 55% of cases, and 20% of children with RHD required one or more cardiac surgeries.
Conclusion:
Children aged less than 5 years living in remote NT are at risk of ARF and RHD. Aboriginal and Torres Strait Islander children are disproportionately affected. Presentations with sore joints, chorea, new cardiac murmurs or other symptoms suggestive of ARF should be fully investigated. Echocardiographic screening for RHD should be considered for children living in remote NT from the age of 3 years.
Related Concept Videos
01:23Rheumatic Heart Disease I: Introduction
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:21Rheumatic Heart Disease III: Medical Management
01:20Rheumatic Heart Disease IV: Nursing Management
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:27Myocarditis II: Clinical Features and Diagnostic Tests