OBJECTIVE: To document a case series of 8 young First Nations @entity1 diagnosed with @entity4789 ( @entity4789 ), a preventable disease that resulted in the death of 2 @entity1 , in northwestern Ontario in the context of late diagnosis, overcrowded housing, and inadequate public health response. DESIGN: Retrospective case series over an 18-month period. SETTING: Remote First Nations communities in northwestern Ontario. @entity1 : Eight @entity1 with @entity4789 . MAIN OUTCOME MEASURES: Incidence, mortality, residual @entity6331 , time to diagnosis, barriers to diagnosis and treatment, housing situation of @entity1 , @entity1 demographic characteristics (age, sex), and investigation results. RESULTS: The incidence of @entity4789 in this population was 21.3 per 100,000, which is 75 times greater than the overall Canadian estimated incidence. The average @entity1 age was 9.4 years. Most cases developed joint findings, and 5 of the surviving @entity1 had @entity6331 when they received echocardiography. The average time to diagnosis was 88 days. Two 4-year-old @entity1 died from @entity4789 . Most @entity1 lived in inadequate and crowded housing. CONCLUSION: This rare disease still exists in remote First Nations communities. These communities demonstrate an incidence equal to that in aboriginal communities in Australia and New Zealand, which have among the highest international incidence of @entity4789 . Primordial prevention, including improved on-reserve housing, is urgently needed. Case detection and ongoing surveillance for primary and secondary prophylaxis requires a well resourced regional strategy.

Acute XXXX in First Nations communities in northwestern Ontario: Social determinants of health "bite the heart".

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient', 'PARTICIPANTS'] @entity4789 :: ('MESH:D012213', 'Disease') :: ['ARF', 'acute rheumatic fever'] @entity6331 :: ('MESH:D012214', 'Disease') :: ['rheumatic heart disease']
@entity4789 :: (MESH:D012213,Disease) :: ['rheumatic fever']
