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Mortality attributable to rheumatic heart disease in the Kimberley: a data linkage approach.
[acute rheumatic fever]
Acute
rheumatic
fever
(
ARF
)
and
its
sequelae
,
rheumatic
heart
disease
(
RHD
)
are
now
uncommon
in
the
general
Australian
population
.
However
,
these
preventable
and
treatable
diseases
continue
to
affect
Aboriginal
Australians
disproportionately
,
especially
in
remote
communities
.
In
the
Kimberley
region
of
Western
Australia
(
WA
)
,
the
prevalence
of
RHD
is
approximately
1
%
among
Aboriginal
residents
.
Yet
an
accurate
and
comprehensive
picture
of
RHD
-related
mortality
is
lacking
.
This
study
aims
to
determine
the
mortality
burden
attributable
to
ARF
and
RHD
in
the
Kimberley
using
linked
hospitalisation
and
death
registry
data
.
A
retrospective
cohort
study
was
undertaken
comprising
all
Kimberley
residents
with
a
WA
hospital
admission
for
ARF
or
RHD
between
1970
and
2010
,
linked
with
the
WA
Death
Register
.
We
manually
classified
RHD
-attributable
deaths
(
'
definite
'
or
'
probable
'
)
to
determine
mortality
burden
.
Hospitalisation
prior
to
death
,
including
valvular
surgery
was
also
ascertained
.
There
were
35
RHD
-attributable
deaths
in
the
Kimberley
between
1990
and
2010
,
with
94
%
occurring
in
Aboriginal
people
.
Their
median
age
of
death
was
40
years
.
The
age-standardised
RHD
annual
death
rate
was
15
.
6
per
100
 
000
with
a
total
of
1100
premature
years
of
life
lost
before
age
of
75
within
this
group
.
Conventional
International
Classification
of
Diseases-generated
mortality
data
underestimated
mortality
burden
.
RHD
remains
a
significant
cause
of
premature
mortality
for
Aboriginal
people
in
the
Kimberley
,
with
mortality
rates
unmatched
in
the
general
Australian
population
since
the
first
half
of
the
20
th
century
.
Efforts
to
reduce
progression
of
this
disease
through
RHD
Register
and
Control
Programs
are
crucial
alongside
action
to
address
underlying
socioeconomic
and
environmental
inequities
.
Diseases
Validation
Diseases presenting
"heart disease"
symptom
22q11.2 deletion syndrome
achondroplasia
acute rheumatic fever
adrenal incidentaloma
child syndrome
classical phenylketonuria
cohen syndrome
congenital diaphragmatic hernia
dentinogenesis imperfecta
esophageal adenocarcinoma
fabry disease
familial mediterranean fever
heparin-induced thrombocytopenia
hirschsprung disease
holt-oram syndrome
homocystinuria without methylmalonic aciduria
kabuki syndrome
monosomy 21
omenn syndrome
phenylketonuria
sneddon syndrome
systemic capillary leak syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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