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Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort.

Rodriguez-Fernandez R, Amiya R, Wyber R, Widdodow W, Carapetis J - Heart Asia (2015)

Bottom Line: The prevalence of RHD in Papuan mining workers correlates with adult prevalence data in other populations with a high RHD burden, highlighting RHD as a significant health issue into adulthood.The late stage at which most patients presented points to a strong need for earlier intervention.Both primary and secondary preventive measures must be considered critical tools to prevent and reduce RHD burden, particularly among older age groups.

View Article: PubMed Central - PubMed

Affiliation: Freeport Public Health and Malaria Control , International SOS , Kuala Kencana, Papua , Indonesia ; NCD Asia Pacific Alliance , Tokyo , Japan.

ABSTRACT

Background: Rheumatic heart disease (RHD) remains a significant cause of cardiovascular morbidity and mortality in developing countries such as Indonesia. Yet, despite being one of the most readily preventable chronic diseases, RHD has received scant research or policy attention, particularly in South-East Asia.

Aim: To describe the pattern of RHD occurrence in a sample of presenting cases from an occupational cohort in Papua Province, Indonesia.

Methods: Clinical records of 15 608 mining workers (96.4% men, mean age 36.3±7.4 years) were reviewed retrospectively to identify and extract data on all rheumatic fever (RF) and RHD cases admitted to two hospitals in Papua during 2008-2013. Collected data included basic demographics, employment history and echocardiographic findings.

Results: 83 RHD cases (95.6% men, mean age 39.6±12.5 years) and 3 RF cases were identified between 2008 and 2013. Increased RHD risk was observed among those aged 35-44 (HR=3.60) and 45-68 (HR=4.46) years relative to the youngest age group (p<0.01). RHD incidence density was 6.84 per 10 000 person years of follow-up. Among cases, mitral stenosis was the most common valvular lesion at initial presentation (41.0%), and 6.0% were multivalvular.

Conclusions: The prevalence of RHD in Papuan mining workers correlates with adult prevalence data in other populations with a high RHD burden, highlighting RHD as a significant health issue into adulthood. The late stage at which most patients presented points to a strong need for earlier intervention. Both primary and secondary preventive measures must be considered critical tools to prevent and reduce RHD burden, particularly among older age groups.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier hazard curve for cumulative probability of rheumatic heart disease diagnosis stratified by age category.
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HEARTASIA2015010641F2: Kaplan–Meier hazard curve for cumulative probability of rheumatic heart disease diagnosis stratified by age category.

Mentions: Kaplan–Meier analyses revealed that the cumulative probability of RHD diagnosis increased at different rates across different age strata for all workers (figure 2). Results of log rank tests indicated that the probabilities of RHD diagnosis among those aged 35–44 years and among those aged 45–68 years were significantly greater than among those aged 18–34 years (p<0.001). After adjustment for gender and employment duration, these trends remained significant; increased RHD risk was observed among those aged 35–44 years (HR 3.60, 95% CI 1.54 to 8.45) and among those aged 45–68 years (HR 4.46, 95% CI 1.57 to 12.63) relative to the youngest age group.


Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort.

Rodriguez-Fernandez R, Amiya R, Wyber R, Widdodow W, Carapetis J - Heart Asia (2015)

Kaplan–Meier hazard curve for cumulative probability of rheumatic heart disease diagnosis stratified by age category.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4537650&req=5

HEARTASIA2015010641F2: Kaplan–Meier hazard curve for cumulative probability of rheumatic heart disease diagnosis stratified by age category.
Mentions: Kaplan–Meier analyses revealed that the cumulative probability of RHD diagnosis increased at different rates across different age strata for all workers (figure 2). Results of log rank tests indicated that the probabilities of RHD diagnosis among those aged 35–44 years and among those aged 45–68 years were significantly greater than among those aged 18–34 years (p<0.001). After adjustment for gender and employment duration, these trends remained significant; increased RHD risk was observed among those aged 35–44 years (HR 3.60, 95% CI 1.54 to 8.45) and among those aged 45–68 years (HR 4.46, 95% CI 1.57 to 12.63) relative to the youngest age group.

Bottom Line: The prevalence of RHD in Papuan mining workers correlates with adult prevalence data in other populations with a high RHD burden, highlighting RHD as a significant health issue into adulthood.The late stage at which most patients presented points to a strong need for earlier intervention.Both primary and secondary preventive measures must be considered critical tools to prevent and reduce RHD burden, particularly among older age groups.

View Article: PubMed Central - PubMed

Affiliation: Freeport Public Health and Malaria Control , International SOS , Kuala Kencana, Papua , Indonesia ; NCD Asia Pacific Alliance , Tokyo , Japan.

ABSTRACT

Background: Rheumatic heart disease (RHD) remains a significant cause of cardiovascular morbidity and mortality in developing countries such as Indonesia. Yet, despite being one of the most readily preventable chronic diseases, RHD has received scant research or policy attention, particularly in South-East Asia.

Aim: To describe the pattern of RHD occurrence in a sample of presenting cases from an occupational cohort in Papua Province, Indonesia.

Methods: Clinical records of 15 608 mining workers (96.4% men, mean age 36.3±7.4 years) were reviewed retrospectively to identify and extract data on all rheumatic fever (RF) and RHD cases admitted to two hospitals in Papua during 2008-2013. Collected data included basic demographics, employment history and echocardiographic findings.

Results: 83 RHD cases (95.6% men, mean age 39.6±12.5 years) and 3 RF cases were identified between 2008 and 2013. Increased RHD risk was observed among those aged 35-44 (HR=3.60) and 45-68 (HR=4.46) years relative to the youngest age group (p<0.01). RHD incidence density was 6.84 per 10 000 person years of follow-up. Among cases, mitral stenosis was the most common valvular lesion at initial presentation (41.0%), and 6.0% were multivalvular.

Conclusions: The prevalence of RHD in Papuan mining workers correlates with adult prevalence data in other populations with a high RHD burden, highlighting RHD as a significant health issue into adulthood. The late stage at which most patients presented points to a strong need for earlier intervention. Both primary and secondary preventive measures must be considered critical tools to prevent and reduce RHD burden, particularly among older age groups.

No MeSH data available.


Related in: MedlinePlus