Acute rheumatic fever and rheumatic heart disease in Fiji: prospective surveillance, 2005-2007.
OBJECTIVE
To determine the incidence and clinical features of acute rheumatic fever (ARF) in Fiji, and the clinical features of patients presenting to hospital in Fiji with rheumatic heart disease (RHD).


METHODS
A prospective surveillance study at the Colonial War Memorial Hospital in Suva over a 23-month period from December 2005 to November 2007.


METHODS
Incidence of ARF; clinical features of ARF and RHD.


RESULTS
The average annualised incidence of definite cases of ARF in children aged 5-15 years was 15.2 per 100,000 (95% CI, 9.0-22.6). The clinical features of ARF were similar to those in classic descriptions. Carditis was very common, occurring in 79% of cases. There were 103 admissions for RHD in which detailed information was collected, with the most common reason for admission being cardiac failure (51%). The median age at admission with RHD was 26.8 years, and there were 10 deaths of patients with RHD (case fatality rate, 9.7%).


CONCLUSIONS
Although apparently declining in incidence since the middle of the 20th century, ARF remains a significant health problem in Fiji. RHD affects young people, leading to premature morbidity and mortality. There is an urgent need for effective control of ARF and RHD in Fiji.
Steer
Andrew C
AC
Centre for International Child Health, University of Melbourne, Melbourne, VIC. andrew.steer@rch.org.au
Kado
Joseph
J
Jenney
Adam W J
AW
Batzloff
Michael
M
Waqatakirewa
Lepani
L
Mulholland
E Kim
EK
Carapetis
Jonathan R
JR
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012213:Rheumatic Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D018570:Risk Assessment; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult