In October 2016, we screened almost 1400 school students aged between 5 and 20. They were examined for skin conditions known to be associated with RHD and then had their hearts examined using echocardiography. This is able to reveal signs of RHD such as damaged valves and abnormal blood flow.

Our study found that Timor-Leste has one of the world’s highest rates of RHD, with 35 borderline and definite cases per thousand. We also found significantly more girls than boys with RHD. Of all the girls screened, 5 per cent (one in 20) had RHD, compared to 2 per cent of boys (one in 50).

The paper recommended that efforts to tackle RHD in Timor-Leste should focus on all levels of prevention. This includes primordial prevention, which addresses the underlying risk factors such as poverty and household crowding; primary prevention (treating strep infections as they occur); and secondary prevention (giving regular penicillin to prevent future strep infections.

The study has been peer-reviewed and published in the Medical Journal of Australia.

You can read more by downloading our summary paper.