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Mortality attributable to rheumatic heart disease in the K imberley: a data linkage approach
Author(s) -
Davies S. B.,
Hofer A.,
Reeve C.
Publication year - 2014
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12540
Subject(s) - medicine , mortality rate , population , pediatrics , retrospective cohort study , heart disease , cohort , epidemiology , cohort study , disease , environmental health
Background Acute rheumatic fever ( ARF ) and its sequelae, rheumatic heart disease ( RHD ) are now uncommon in the general A ustralian population. However, these preventable and treatable diseases continue to affect A boriginal A ustralians disproportionately, especially in remote communities. In the K imberley region of W estern A ustralia ( WA ), the prevalence of RHD is approximately 1% among A boriginal residents. Yet an accurate and comprehensive picture of RHD ‐related mortality is lacking.Aim This study aims to determine the mortality burden attributable to ARF and RHD in the K imberley using linked hospitalisation and death registry data. Methods A retrospective cohort study was undertaken comprising all K imberley residents with a WA hospital admission for ARF or RHD between 1970 and 2010, linked with the WA D eath R egister. We manually classified RHD ‐attributable deaths (‘definite’ or ‘probable’) to determine mortality burden. Hospitalisation prior to death, including valvular surgery was also ascertained. Results There were 35 RHD ‐attributable deaths in the Kimberley between 1990 and 2010, with 94% occurring in A boriginal 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. Conclusion RHD remains a significant cause of premature mortality for Aboriginal people in the K imberley, with mortality rates unmatched in the general A ustralian population since the first half of the 20th century. Efforts to reduce progression of this disease through RHD R egister and C ontrol P rograms are crucial alongside action to address underlying socioeconomic and environmental inequities.