Ten Years of Acute Rheumatic Fever and Rheumatic Heart Disease in Fiji: A Retrospective Epidemiological Analysis of Morbidity — The Association Specialists
  1. Schedule
  2. Oral Presentations - Health and wellbeing (general)
  3. Ten Years of Acute Rheumatic Fever and Rheumatic Heart Disease in Fiji: A Retrospective Epidemiological Analysis of Morbidity

Ten Years of Acute Rheumatic Fever and Rheumatic Heart Disease in Fiji: A Retrospective Epidemiological Analysis of Morbidity (23937)

Bridget Kool 1 , Jyoti Mani 2 , Roneel Chandra 2 , Maria Mow 2 , Jimaima Kailawadoko-Matanaicake 2 , Poona Pal 3 , Bert van der Werf 1 , Sue McAllister 4 , Devina Nand 3 , Rachel Pillay 3 , Alisha Sahukhan 3 , Eric Rafai 5 , Philip Hill 4 , Andrew Steer 6 , Braden Te Ao 1 , Cameron Grant 1 , Chris Bullen 1 , Bridget Kool 1 , Donald Wilson 7 , Stephen Howie 1
  1. University of Auckland, Auckland, New Zealand
  2. Cure Kids, Suva, Fij
  3. Ministry of Health and Medical Sciences, Suva, Fiji
  4. University of Otago, Dunedin, New Zealand
  5. Pacific Community, Suva, Fiji
  6. Murdoch Children’s Research Institute, Melbourne, Australia
  7. Fiji National Univesity, Suva, Fiji

Background

Fiji has amongst the world’s highest prevalence rates of rheumatic heart disease (RHD). Understanding the epidemiology of acute rheumatic fever (ARF) and RHD is critical for identifying high‑risk populations and informing targeted prevention and screening strategies.

Methods

A retrospective review of ARF and RHD registered cases in Fiji was undertaken (January 2005 - December 2022). Cases were identified using ICD‑10 codes and linked using encrypted National Health Numbers. Analyses were stratified by age, sex, ethnicity, and geographic location.  

Results                              

Of the 5,332 cases recorded in the National RHD/ARF Register, 543 (10%) had ARF, of which half were male, more than half were children (0 – 19 years), and over two-thirds iTaukei (indigenous Fijians).  The highest burden occurred in the 0–9 and 10–19-year age groups, accounting for 88% of ARF diagnoses.

RHD accounted for 4,789 of cases (90%), and was more common among females (60%), iTaukei (72%) and adults (77%), with 56% of cases occurring in the 15–29-year age group.

Among 4,435 RHD/ARF hospital admissions, 831 (19%) were for ARF (68% of which were aged 0–19‑years) and 3,604 (81%) for RHD (60% female, 68% iTaukei). The median admission length of stay was 4.5 days (IQR 4.2–4.8) for ARF and 5.6 days (IQR 5.4–5.8) for RHD.

Age‑specific RHD incidence, were highest in children and young people - 158/100,000 among 10–14-year-olds, 77/100,000 among 15-19-year-olds, 75/100,000 among 5–9-year-olds. Incidence rates were higher among females (56/100,000 versus males 39/100,000) and Fijians of Other descent (76/100,000) and iTaukei (60/100,000).

Conclusion

The patterns of ARF and RHD in Fiji highlight ongoing transmission and progression, reinforcing the need for strengthened prevention, early detection, and secondary prophylaxis.