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Acute rheumatic fever and rheumatic heart disease in the Kimberley: using hospitalisation data to find cases and describe trends.
[acute rheumatic fever]
Objective
:
To
describe
the
epidemiology
of
hospitalisations
due
to
acute
rheumatic
fever
(
ARF
)
and
rheumatic
heart
disease
(
RHD
)
in
the
Kimberley
region
of
Western
Australia
(
WA
)
and
use
these
data
to
improve
completeness
of
the
WA
RHD
Register
.
Methods
:
Retrospective
analysis
of
Kimberley
regional
hospitalisation
data
for
hospitalisations
coded
as
ARF
/
RHD
from
01
/
07
/
2002
to
30
/
06
/
2012
,
with
individual
follow-up
of
those
not
on
the
register
.
Annual
age-standardised
hospitalisation
rates
were
calculated
to
determine
hospitalisation
trend
.
Results
:
There
were
250
admissions
among
193
individuals
.
Of
these
,
53
individuals
(
27
%
)
with
confirmed
or
probable
ARF
/
RHD
were
not
on
the
register
.
Males
were
less
likely
to
be
on
the
register
(
62
%
versus
79
%
of
females
,
p
<
0
.
01
)
,
as
were
those
hospitalised
with
ARF
without
heart
involvement
(
68
%
versus
87
%
of
other
ARF
diagnoses
,
p
<
0
.
01
)
.
ARF
/
RHD
hospitalisation
rates
decreased
by
8
.
8
%
per
year
(
p
<
0
.
001
,
rate
ratio
=
0
.
91
,
95
%
CI
0
.
87
-
0
.
96
)
.
Conclusions
and
implications
:
Using
hospitalisation
data
is
an
effective
method
of
identifying
cases
of
ARF
/
RHD
not
currently
on
the
register
.
This
process
could
be
undertaken
for
initial
case
finding
in
areas
with
newly
established
registers
,
or
as
regular
quality
assurance
in
areas
with
established
register-based
programs
.
Reasons
for
the
observed
decrease
in
hospitalisation
rates
remain
unclear
and
warrant
further
investigation
.
