{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:03:36Z","timestamp":1765231416176,"version":"3.46.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018853","name":"Common Good","doi-asserted-by":"publisher","award":["NI203 \u201011"],"award-info":[{"award-number":["NI203 \u201011"]}],"id":[{"id":"10.13039\/501100018853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2025,12,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the incidence and prevalence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in Queensland during the period 2017\u20132021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Population\u2010level retrospective cohort study using linked administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting, participants<\/jats:title>\n                    <jats:p>Queensland residents aged younger than 45 years for ARF and younger than 55 years for RHD, identified from hospital, emergency department, death and Queensland RHD Register records for the period 1 January 2017 to 31 December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Age\u2010specific and age\u2010standardised incidence and prevalence of ARF and RHD; and age\u2010standardised incidence and prevalence ratios comparing Indigenous and non\u2010Indigenous populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>736 ARF episodes occurred among 670 people (395 [54%] female participants; 609 [83%] Indigenous). Of 4519 prevalent RHD cases aged &lt;\u200955 years who were alive on 1 July 2021, 2655 (59%) were female, 2169 (48%) were Indigenous, and 1846 (41%) had severe disease. Previous ARF was recorded for 362 cases (8%). Among RHD cases aged younger than 25 years, 633 of 790 Indigenous individuals (80%) and 133 of 408 non\u2010Indigenous individuals (33%) had RHD Register records. Indigenous age\u2010standardised incidence (&lt;\u200945 years) was 60.2 times higher (95% CI, 55.6\u201364.2) than non\u2010Indigenous incidence for first ever ARF, 68.6 times higher (95% CI, 62.3\u201372.5) for total ARF, and 18.9 times higher (95% CI, 13.5\u201324.1) for RHD. For Indigenous people aged &lt;\u200955 years, prevalence was 22.6 times higher (95% CI, 16.2\u201327.3) for ARF\/RHD, 18.4 times higher (95% CI, 12.9\u201324.1) for RHD, and 12.1 times higher (95% CI, 8.3\u201315.9) for severe RHD. The overall burden of ARF and RHD was highest in northern Queensland health districts, whereas cases in the non\u2010Indigenous population were concentrated in metropolitan south\u2010east Queensland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The vast disparity in ARF and RHD burden between Indigenous and non\u2010Indigenous Queenslanders indicates an urgent need for targeted, community\u2010led prevention strategies. Under\u2010representation of non\u2010Indigenous youth in the RHD Register suggests improved clinical awareness and reporting is needed. Further investigation is warranted to inform equitable responses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70052","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T09:32:03Z","timestamp":1758533523000},"page":"576-585","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The epidemiology of acute rheumatic fever and rheumatic heart disease in Queensland, 2017\u20132021: a population\u2010level cohort study using linked administrative data"],"prefix":"10.5694","volume":"223","author":[{"given":"Carl J","family":"Francia (Saibai Koedal awgadhalayg, Guda Maluylgal Nation)","sequence":"first","affiliation":[{"name":"University of Queensland  Brisbane QLD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leanne M","family":"Johnston","sequence":"additional","affiliation":[{"name":"Queensland Children\u2019s Hospital  Brisbane QLD"}],"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 University of Western Australia  Perth WA"},{"name":"University of Western Australia  Perth WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert N","family":"Justo","sequence":"additional","affiliation":[{"name":"Queensland Children\u2019s Hospital  Brisbane QLD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F","family":"Fraser","sequence":"additional","affiliation":[{"name":"University of Queensland  Brisbane QLD"},{"name":"Prince Charles Hospital  Brisbane QLD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith M","family":"Katzenellenbogen","sequence":"additional","affiliation":[{"name":"University of Western Australia  Perth WA"},{"name":"Kids Research Institute Australia  Perth WA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.016851"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50853"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52222"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH24148"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52350"},{"volume-title":"Ending Rheumatic Heart Disease: Queensland First Nations Strategy 2021\u20132024 final report","year":"2024","author":"Health Queensland","key":"e_1_2_10_6_1"},{"key":"e_1_2_10_7_1","unstructured":"Hospital and Health Boards (Health Equity Strategies) Amendment Regulation2021(Qld).https:\/\/www.legislation.qld.gov.au\/view\/pdf\/asmade\/sl\u20102021\u20100034(viewed Oct 2024)."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH23273"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-019-0815-8"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S224621"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S241588"},{"volume-title":"Indigenous identification in hospital separations data: quality report (AIHW Cat. 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