{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:40:26Z","timestamp":1792798826437,"version":"4.5.0"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Heart Foundation, Cure Kids","award":["13\/965"],"award-info":[{"award-number":["13\/965"]}],"id":[{"id":"https:\/\/ror.org\/04es60x64","id-type":"ROR","asserted-by":"crossref"}]},{"name":"the Health Research Council of New Zealand, Rheumatic Fever Partnership","award":["HRC 13\/965"],"award-info":[{"award-number":["HRC 13\/965"]}],"id":[{"id":"https:\/\/ror.org\/00zbf3d93","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,3,29]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite numerous echocardiographic screening studies of children in high incidence acute rheumatic fever (ARF)\/rheumatic heart disease (RHD) communities, little is known about the prevalence of RHD in adults in these populations.<\/jats:p>\n                    <jats:p>We sought to determine the prevalence of RHD in an urban area of South Auckland, New Zealand, where previous studies had shown the prevalence of RHD in children to be around 2%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional screening study was conducted between 2014 and 2016. Echocardiography clinics were conducted at an urban Pacific-led primary healthcare clinic in New Zealand. Eligible persons aged 16\u201340 years were recruited according to a stratified randomised approach. Echocardiograms were performed with a standardised image acquisition protocol and reported by cardiologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 465 individuals who underwent echocardiograms. The overall prevalence of RHD (define and borderline) was 56 per 1000 (95% CI 36 to 78 per 1000). Definite RHD was found in 10 individuals (4 of whom were already under cardiology review at a hospital clinic) with a prevalence of 22 per 1000 (95% CI 9 to 36 per 1000). Non-rheumatic cardiac abnormalities were found in 29 individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a high burden of both rheumatic and non-rheumatic cardiac abnormalities in this population. Rates described in New Zealand are as high as lower-middle-income countries in Africa. Addressing knowledge gaps regarding the natural history of RHD detected by echocardiography in adults is a priority issue for the international RHD community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002253","type":"journal-article","created":{"date-parts":[[2023,4,30]],"date-time":"2023-04-30T14:05:10Z","timestamp":1682863510000},"page":"e002253","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["High burden of rheumatic heart disease confirmed by echocardiography among Pacific adults living in New Zealand"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9855-3919","authenticated-orcid":false,"given":"Rachel","family":"Webb","sequence":"first","affiliation":[{"name":"Department of Paediatrics: Child and Youth Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand"},{"name":"Kidz First Children's Hospital, Te Whatu Ora, Counties Manukau, Auckland, New Zealand"},{"name":"Department of Paediatric Infectious Diseases, Te Whatu Ora, Starship Children's Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Culliford-Semmens","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Congenital Cardiac Services, Te Whatu Ora, Starship Children's Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"ChanMow","sequence":"additional","affiliation":[{"name":"South Seas Health Care Integrated Family Health Centre, Manukau, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Doughty","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Tilton","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Congenital Cardiac Services, Te Whatu Ora, Starship Children's Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briar","family":"Peat","sequence":"additional","affiliation":[{"name":"Department of Medicine, South Auckland Clinical School, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Stirling","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Congenital Cardiac Services, Te Whatu Ora, Starship Children's Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L","family":"Gentles","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Congenital Cardiac Services, Te Whatu Ora, Starship Children's Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel J","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Congenital Cardiac Services, Te Whatu Ora, Starship Children's Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,30]]},"reference":[{"key":"2025081709451046000_10.1.e002253.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.010"},{"key":"2025081709451046000_10.1.e002253.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603693"},{"key":"2025081709451046000_10.1.e002253.3","doi-asserted-by":"crossref","DOI":"10.1093\/eurheartj\/ehy764","article-title":"WHO resolution on rheumatic heart disease","volume":"39","author":"White","year":"2018","journal-title":"Eur Heart 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