• Internal medicine journal · Nov 2014

    Mortality attributable to rheumatic heart disease in the Kimberley: a data linkage approach.

    • S B Davies, A Hofer, and C Reeve.
    • Kimberley Population Health Unit, Yamamoto House, Broome, Western Australia, Australia.
    • Intern Med J. 2014 Nov 1; 44 (11): 107410801074-80.

    BackgroundAcute 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.AimThis study aims to determine the mortality burden attributable to ARF and RHD in the Kimberley using linked hospitalisation and death registry data.MethodsA 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.ResultsThere 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.ConclusionRHD 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 20th 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.© 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

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