title: Heart disease in East Timor: cross-sectional analysis of 474 patients attending Timor-Leste's first cardiology service.
abstract: BACKGROUND
  East Timor is a developing country and is a close neighbour of Australia. The prevalence of cardiac disease is unknown.
  
  
  OBJECTIVE
  To describe the prevalence and patterns of cardiac disease in patients attending the first cardiology service of Timor-Leste.
  
  
  METHODS
  A cross-sectional retrospective analysis was performed of demographic and clinical data of 474 unique patients referred to outpatient cardiology clinics conducted in East Timor from 2003 to 2016.
  
  
  RESULTS
  Mean age was 29.9 ± 18.5 years, with females significantly younger than males (28.8 ± 16.9 vs 32.3 ± 20.6 years). Congenital cardiac disease patients were the youngest (15.5 ± 13.9 years) and cardiomyopathy patients the oldest (46.7 ± 17.8 years). Of patients with rheumatic heart disease, the majority had mitral stenosis (59.4%) and multi-valvular involvement (61.6%). Of note, 28.3% of patients with rheumatic heart disease presented with severe mitral stenosis. Amongst congenital heart disease patients, the most common diagnosis was atrial or ventricular septal defects (61% combined). A total of 19.2% of patients either required immediate referral for intervention or palliation for their cardiac disease. Patients referred to Australia for treatment were significantly younger (19.7 ± 11.7 years) than all other outcome groups.
  
  
  CONCLUSIONS
  Amongst young East Timorese, rheumatic heart disease and unrepaired congenital cardiac defects impose a significant burden. One-fifth of patients present to clinics with severe disease requiring urgent referral for surgery or palliation.
authors.affiliation: East Timor Hearts Fund, Melbourne, Victoria, Australia.|St Vincent's Health Melbourne, Melbourne, Victoria, Australia.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Paratz
authors.affiliation: East Timor Hearts Fund, Melbourne, Victoria, Australia.
authors.forename: Noel
authors.initials: N
authors.lastname: Bayley
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006301:Health Services Needs and Demand; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D008507:Medically Underserved Area; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012017:Referral and Consultation / Q000458:organization & administration*; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000453:epidemiology*; D049648:Timor-Leste / Q000453:epidemiology
keywords: Australasia; congenital; global health; rheumatic heart disease