Background:
Rheumatic heart disease (RHD) is a significant public health issue in Timor-Leste, a resource-limited, post-conflict nation with barriers to healthcare access. Maluk Timor, in partnership with the Ministry of Health, runs an RHD program to identify cases, support treatment and follow up, and improve surveillance.
Methods:
This study analyzed data from 587 patients recorded in the Maluk Timor RHD register, which includes cases identified through echocardiographic screening and clinical presentations across the country. However, it is not an exhaustive record of all cases. The dataset comprises demographics, clinical history, echocardiographic findings, outcomes, and interventions.
Results:
Demographically, females account for 65% of cases, while males constitute 35%. The most affected age group is 15–24 years (52%), followed by 5–14 years (25%). Among initial diagnoses, severe RHD is the most prevalent (29%), followed by mild (26%) and moderate RHD (11%). Borderline RHD is reported in 10% of cases, and 13% have acute rheumatic fever (ARF) without RHD. At initial diagnosis, the majority of patients have mitral regurgitation or mitral stenosis (60%), or both mitral and aortic manifestations (35%). Cardiac failure has occurred in 8% of cases (49 patients). Surgical interventions, including valve repairs and replacements, have been performed in 5% of cases (32 patients).
Conclusions:
RHD primarily affects young individuals and females in Timor-Leste, with severe disease frequently identified at screening or uncovered at patient attendance at hospital. The high prevalence of severe disease and complications alongside limited surgical interventions highlights the need for improved early detection, treatment access, and prevention.