Acute rheumatic fever

This section discusses diagnoses of acute rheumatic fever (ARF) reported by Australian rheumatic heart disease (RHD) control programs between 2014 and 2018. The total number of ARF diagnoses recorded is dependent on the reporting practices to the various RHD registers. A person may have multiple diagnoses of ARF in their lifetime, so the number of diagnoses is greater than the number of people affected. Cases are allocated to a jurisdiction and region based on where they were diagnosed with ARF.

It is likely that ARF diagnoses are under-reported to RHD registers in all jurisdictions. Although the registers in each state and territory were functional for the entire analysis period, they were relatively new in some states (Box 1). Clinician awareness and reporting to the registers is likely to have increased in the years since register commencement, and may also have been affected by the addition of ARF and RHD to the list of notifiable diseases at different times in the various jurisdictions. However, under-diagnosis and under-reporting to the register also means some individuals are not captured in this analysis. It is difficult to determine whether increases in the number of diagnoses reflect a real increase in the number of cases occurring, improved detection and diagnosis of cases, or increases in the number of people being recorded on the registers.

Box 1: Acute rheumatic fever/rheumatic heart disease registers

All jurisdictions with RHD registers have different notification and data collection practices and therefore the numbers, data quality and completeness in the RHD registers are variable. Table 1 summarises the timeline of program and register establishment across the jurisdictions.

Refer to Jurisdictional RHD control programs and registers for more information.

 

NSW

Qld

WA

SA

NT

Vic, Tas, ACT

Table 1: Timeline of program and register establishment

RHD control program

2015

2009

2009

2010

1997(a)

ARF/RHD register

2016

2006

2009

2012

1997

Definite ARF notifiable

2015

1999

2007

2016

1996

Probable ARF notifiable

2015

2015

2016

2019

Possible ARF notifiable

2015

2016

Confirmed RHD notifiable

2015(b)

2018

2015

2016

2019

Borderline RHD notifiable

2018

2015

2016

  1. The Top End Control Program was established in Darwin in 1997, and expanded in 2000 to include the whole Northern Territory.
  2. In NSW, RHD is only notifiable in persons aged less than 35 years.

Source: RHD Australia (ARF/RHD writing group) 2020.