PM471 Mortality amongst patients with rheumatic heart disease in Fiji: a national historic data-linkage cohort study

Parks, Tom; Kado, Joseph; Miller, Anne; Ward, Brenton; Heenan, Rachel; Colquhoun, Samantha; Tukana, Isimeli; Steer, Andrew C.

doi:10.1016/j.gheart.2014.03.1791

Cited by 3 publications

(4 citation statements)

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“…Increased mortality from RHD in young people is seen elsewhere in high‐prevalence, resource‐poor countries, although limited population‐based mortality data are available to quantify this observation, and further studies are required . A recent examination of the Fiji RHD national register and clinical data has shown that the risk of death of patients with RHD is increased 8.8 times compared with the general population; this risk is greatest among young Indigenous men (DRR 50, 95% CI 35.0 to 69.2) compared with the non‐Indigenous Fijian population …”

Section: Discussionmentioning

confidence: 99%

“…Increased mortality from RHD in young people is seen elsewhere in high-prevalence, resource-poor countries, although limited population-based mortality data are available to quantify this observation, and further studies are 26 Over time, RHD mortality in Australia has decreased much more for the non-Indigenous population (7.4% per year) than for the Indigenous population (1.8% per year). Non-Indigenous Australians were also more likely to die from other causes, with RHD contributing as an associated, rather than the underlying, cause of death.…”

Section: Discussionmentioning

confidence: 99%

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Disparity in Mortality From Rheumatic Heart Disease in Indigenous Australians

Colquhoun

Condon

Steer

et al. 2015

JAHA

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BackgroundRecent estimates of the global burden of rheumatic heart disease (RHD) have highlighted the paucity of reliable RHD mortality data from populations most affected by RHD.Methods and ResultsWe investigated RHD mortality rates and trends for Indigenous and non-Indigenous Australians in the Northern Territory (NT) for the period 1977–2005 and seminationally (NT plus 4 other states, covering 89% of Indigenous Australians) from 1997 to 2005 using vital statistics data. All analysis was undertaken by Indigenous status, sex, and age at death. In the NT, 90% of all deaths from RHD were among Indigenous persons; however, the Indigenous population makes up only 30.4% of the NT population. The death rate ratio (Indigenous compared with non-Indigenous) was 54.80 in the NT and 12.74 in the other 4 states (estimated at the median age of 50 years). Non-Indigenous death rates were low for all age groups except ≥65 years, indicating RHD deaths in the elderly non-Indigenous population. Death rates decreased at a more rapid rate for non-Indigenous than Indigenous persons in the NT between 1997 and 2005. Indigenous persons in other parts of Australia showed lower death rates than their NT counterparts, but the death rates for Indigenous persons in all states were still much higher than rates for non-Indigenous Australians.ConclusionsIndigenous Australians are much more likely to die from RHD than other Australians. Among the Indigenous population, RHD mortality is much higher in the NT than elsewhere in Australia, exceeding levels reported in many industrialized countries more than a century ago. With the paucity of data from high-prevalence areas, these data contribute substantially to understanding the global burden of RHD mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Disparity in Mortality From Rheumatic Heart Disease in Indigenous Australians

Colquhoun

Condon

Steer

et al. 2015

JAHA

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“…An earlier version of this study based on a deterministic record-linkage procedure was presented at the World Congress of Cardiology 2014. [ 40 ]…”

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confidence: 99%

Rheumatic Heart Disease-Attributable Mortality at Ages 5–69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study

et al. 2015

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BackgroundRheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008–2012 in people aged 5–69 years.Methods and FindingsUsing 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8–10.0) and 331 years of life-lost (YLL, 95% CI 330.4–331.5) due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0–69 years. Valuing life using Fiji’s per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011–2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses.ConclusionsRheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases.

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“…Complications arising from RHD during pregnancy also cause significant morbidity and mortality; in Nepal, pregnant women with RHD had a mortality rate of 4% and foetal and neonatal mortality was 16% [28]. Parks et al [29] measured the mortality of RHD patients in Fiji; the standardized mortality ratio was 8.8 compared with the general population. Young indigenous Fijian men with RHD had the highest standardized mortality ratio at 50.0.…”

Section: Introductionmentioning

confidence: 99%