Indigenous children and young peoples live with an inequitable burden of acute rheumatic fever and rheumatic heart disease. In this Review, we focus on the epidemiological burden and lived experience of these conditions for Indigenous young peoples in Australia, New Zealand, and Canada. We outline the direct and indirect drivers of rheumatic heart disease risk and their mitigation. Specifically, we identify the opportunities and limitations of predominantly biomedical approaches to the primary, secondary, and tertiary prevention of disease among Indigenous peoples. We explain why these biomedical approaches must be coupled with decolonising approaches to address the underlying cause of disease. Initiatives underway to reduce acute rheumatic fever and rheumatic heart disease in Australia, New Zealand, and Canada are reviewed to identify how an Indigenous rights-based approach could contribute to elimination of rheumatic heart disease and global disease control goals.

土著儿童和年轻人的急性风湿热和风湿性心脏病负担不均。在本综述中，我们关注澳大利亚，新西兰和加拿大的土著年轻人的流行病学负担和这些条件的生活经验。我们概述了风湿性心脏病风险及其缓解的直接和间接驱动因素。具体而言，我们确定了主要的生物医学方法在原住民中对疾病的一级，二级和三级预防的机会和局限性。我们解释了为什么必须将这些生物医学方法与非殖民化方法结合起来以解决疾病的根本原因。在澳大利亚，新西兰，