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Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010.
[acute rheumatic fever]
Although
acute
rheumatic
fever
(
ARF
)
and
its
sequel
,
rheumatic
heart
disease
(
RHD
)
,
continue
to
cause
a
large
burden
of
morbidity
and
mortality
in
disadvantaged
populations
,
most
studies
investigating
the
effectiveness
of
control
programs
date
from
the
1950
s
.
A
control
program
,
including
a
disease
register
,
in
the
Northern
Territory
of
Australia
where
the
Indigenous
population
has
high
rates
of
ARF
and
RHD
allowed
us
to
examine
current
disease
incidence
and
progression
.
ARF
and
RHD
incidence
rates
,
ARF
recurrence
rates
,
progression
rates
from
ARF
to
RHD
to
heart
failure
,
and
RHD
survival
and
mortality
rates
were
calculated
for
Northern
Territory
residents
from
1997
to
2010
.
For
Indigenous
people
,
ARF
incidence
was
highest
in
the
5
-
to
14
-
year
age
group
(
males
,
162
per
100
,
000
;
females
,
228
per
100
,
000
)
.
There
was
little
evidence
that
the
incidence
of
ARF
or
RHD
had
declined
.
The
ARF
recurrence
rate
declined
by
9
%
per
year
after
diagnosis
.
After
a
first
ARF
diagnosis
,
61
%
developed
RHD
within
10
years
.
After
RHD
diagnosis
,
27
%
developed
heart
failure
within
5
years
.
For
Indigenous
RHD
patients
,
the
relative
survival
rate
was
88
.
4
%
at
10
years
after
diagnosis
and
the
standardized
mortality
ratio
was
1
.
56
(
95
%
confidence
interval
,
1
.
23
-
1
.
96
)
.
For
Indigenous
Australians
in
the
Northern
Territory
,
ARF
and
RHD
incidence
and
associated
mortality
remain
very
high
.
The
reduction
in
ARF
recurrence
indicates
that
the
RHD
control
program
has
improved
secondary
prophylaxis
;
a
decline
in
RHD
incidence
is
expected
to
follow
.
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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