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Demographic\/clinical profiles and pre\u2010diagnosis healthcare interactions were analysed with stratification into 5\u2010year age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cross\u2010sectional linked administrative data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Northern Territory, South Australia, Queensland and Western Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children aged &lt;\u200915\u2009years at first hospitalisation or notification for ARF or RHD, 2001\u20132017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Disease stage and severity at diagnosis, register notification status, clinical history prior to ARF or RHD diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2382 children diagnosed with ARF\/RHD aged &lt;\u200915\u2009years, 180 (7.6%) were aged under 5\u2009years. Among under 5\u2010year\u2010olds with ARF or RHD, 30.6% had not been notified to RHD registers. A total 49 under 5\u2010year\u2010olds were diagnosed with RHD; with 22 (44.9%) classified as having mild disease, 16 (32.7%) moderate and 6 (12.2%) severe. High hospitalisation rates for injury in the first year of life were observed for the &lt;\u20095\u2010year\u2010old cohort with ARF\/RHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We present the first comprehensive Australian evidence that ARF and RHD diagnoses are occurring in Australian children aged under 5\u2009years. Greater awareness among clinicians is needed regarding ARF\/RHD as a potential diagnosis in this young, high risk age group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajr.70135","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T08:38:22Z","timestamp":1768379902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Linked Data Analysis of Acute Rheumatic Fever and Rheumatic Heart Disease Diagnoses in Children Aged Under Five Years in Australia, 2001\u20132017"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7251-9157","authenticated-orcid":false,"given":"Jamie","family":"Cransberg","sequence":"first","affiliation":[{"name":"Cardiovascular Epidemiology Research Centre, School of Population and Global Health University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Katzenellenbogen","sequence":"additional","affiliation":[{"name":"Cardiovascular Epidemiology Research Centre, School of Population and Global Health University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Remenyi","sequence":"additional","affiliation":[{"name":"Charles Darwin University, Menzies School of Health Research  Darwin Northern Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Francia","sequence":"additional","affiliation":[{"name":"University of Queensland, School of Health and Rehabilitation Sciences  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Murray","sequence":"additional","affiliation":[{"name":"Cardiovascular Epidemiology Research Centre, School of Population and Global Health University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-6031","authenticated-orcid":false,"given":"Ingrid","family":"Stacey","sequence":"additional","affiliation":[{"name":"Cardiovascular Epidemiology Research Centre, School of Population and Global Health University of Western Australia  Perth Western Australia Australia"},{"name":"Victor Chang Cardiac Research Institute, Cardiology Population Health Laboratory  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.84"},{"issue":"10","key":"e_1_2_13_3_1","first-page":"S3","article-title":"Ending Rheumatic Heart Disease in Australia: The Evidence for a New Approach","volume":"213","author":"Wyber R.","year":"2020","journal-title":"Medical Journal of Australia"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603693"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.016851"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S224621"},{"issue":"20","key":"e_1_2_13_7_1","first-page":"555","article-title":"Acute Rheumatic Fever and Rheumatic Heart Disease Among Children\u2013American Samoa, 2011\u20132012","volume":"64","author":"Beaudoin A.","year":"2015","journal-title":"MMWR. 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