TY - JOUR
T1 - A national prospective surveillance study of acute rheumatic fever in Australian children
AU - Noonan, Sara
AU - Zurynski, Yvonne A.
AU - Currie, Bart J.
AU - McDonald, Malcolm
AU - Wheaton, Gavin
AU - Nissen, Michael
AU - Curtis, Nigel
AU - Isaacs, David
AU - Richmond, Peter
AU - Ramsay, James M.
AU - Elliott, Elizabeth J.
AU - Carapetis, Jonathan R.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/1
Y1 - 2013/1
N2 - Background: Acute rheumatic fever (ARF) is an important cause of heart disease in Indigenous people of northern and central Australia. However, little is known about ARF in children across all Australian population groups. This national prospective study was conducted to determine patterns of disease, and populations and regions at highest risk. Methods: The Australian Paediatric Surveillance Unit surveillance model was used to collect data on children with ARF across Australia. Children up to 15 years of age were included if they had an ARF episode diagnosed between October 1, 2007 and December 31, 2010 that met the case definition. Results: ARF was identified in 151 children: 131 Indigenous Australians, 10 non-Indigenous Australians, 8 Pacific Islanders and 1 African (1 unknown). Common presenting features were joint symptoms, fever and carditis. Sydenham chorea was reported in 19% of children. Aseptic monoarthritis was a major manifestation in 19% of high-risk children. Seven non-Indigenous Australian children presented with classic, highly specific features compared with 23% of high-risk children, suggesting that subtle presentations of ARF are being missed in non-Indigenous children. Recent sore throat was reported in 33% of cases, including 25% of remote Indigenous children. There were delays in presentation to care and referral to higher-level care across urban/rural and remote areas. Conclusions: ARF may be more common than previously thought among low-risk children. These data should prompt an awareness of ARF diagnosis and management across all regions, including strategies for primary prevention. There should be renewed emphasis on treatment of sore throat in high-risk groups.
AB - Background: Acute rheumatic fever (ARF) is an important cause of heart disease in Indigenous people of northern and central Australia. However, little is known about ARF in children across all Australian population groups. This national prospective study was conducted to determine patterns of disease, and populations and regions at highest risk. Methods: The Australian Paediatric Surveillance Unit surveillance model was used to collect data on children with ARF across Australia. Children up to 15 years of age were included if they had an ARF episode diagnosed between October 1, 2007 and December 31, 2010 that met the case definition. Results: ARF was identified in 151 children: 131 Indigenous Australians, 10 non-Indigenous Australians, 8 Pacific Islanders and 1 African (1 unknown). Common presenting features were joint symptoms, fever and carditis. Sydenham chorea was reported in 19% of children. Aseptic monoarthritis was a major manifestation in 19% of high-risk children. Seven non-Indigenous Australian children presented with classic, highly specific features compared with 23% of high-risk children, suggesting that subtle presentations of ARF are being missed in non-Indigenous children. Recent sore throat was reported in 33% of cases, including 25% of remote Indigenous children. There were delays in presentation to care and referral to higher-level care across urban/rural and remote areas. Conclusions: ARF may be more common than previously thought among low-risk children. These data should prompt an awareness of ARF diagnosis and management across all regions, including strategies for primary prevention. There should be renewed emphasis on treatment of sore throat in high-risk groups.
KW - Australia
KW - children
KW - rheumatic fever
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=84871781242&partnerID=8YFLogxK
U2 - 10.1097/INF.0b013e31826faeb3
DO - 10.1097/INF.0b013e31826faeb3
M3 - Article
C2 - 22926211
AN - SCOPUS:84871781242
SN - 0891-3668
VL - 32
SP - e26-e32
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 1
ER -