Australia has one of the highest rates of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in the world. Indigenous people are up to eight times more likely than other groups to be hospitalised and nearly 20 times as likely to die from this disease.
ARF is caused by an immunological response to group A streptococcal (GAS) infection and can lead to permanent heart damage, a condition known as RHD. Globally, RHD is the most common cause of cardiac death in children and adults aged under 40 years. However, through simple and cost effective strategies, almost all cases of RHD and associated deaths are preventable.
There are at least 15.6 million people with RHD worldwide and, annually, over 230 000 people die from the disease. There are another 1.9 million people with a history of ARF and 470 000 new cases are diagnosed every year. These figures, however, are likely to be an underestimate of the true burden of the disease.
Some of the highest rates of ARF and RHD in the world are found in Indigenous Australians (particularly across central and northern Australia), Maoris and Pacific Island populations. The Pacific region, including Fiji, has the highest reported prevalence of RHD. The prevalence of RHD is also high in sub-Saharan Africa, Latin America, the Indian subcontinent, the Middle East and Northern Africa. Menzies' researchers work with high risk populations in Australia and the Pacific Region.
Incidence of ARF and RHD falls dramatically with improved living conditions and increased hygiene standards, along with better access to appropriate health services and penicillin-based medications (known as secondary prophylaxis).
Menzies’ research mainly targets primary and secondary prevention of ARF and RHD. This means stopping people from getting the disease in the first place, but if they do get it, treating them to keep them healthy.
Our research focus:
- To test whether a model of care designed to optimise health systems and community resources improves adherence to secondary prophylaxis for RHD
- To understand why ARF converts to RHD in some people. Many Indigenous Australians will get group A streptococcus infections but only some will develop RHD. Launched in 2012, RHD Genetics is a collaborative study into the role genetics plays in the disease’s presence and progression
- To provide an evidence base to improve clinical care and outcomes for women with RHD in pregnancy and for their babies
- To find markers in the blood that can be used to rapidly and accurately diagnose ARF so people can get the treatment they need as soon as possible
- To establish the prevalence of RHD in high-risk Indigenous Australian children and to compare the findings with children at low risk for RHD and to determine the accuracy of cardiac auscultation in detecting echocardiographically- confirmed RHD
- To provide direct program support and conduct research under the World Heart Federation RHD Pacific and International Program, including:
- RHD genetics study in Fiji and New Caledonia.
- A BPG adherence study in Fiji
- A cost analysis of burden of RHD in New Caledonia and Fiji
- An evaluation of the ASAP RHD program in South Africa and Ethiopia
- Development of an RHD train the trainer module for international and regional Pacific use
- Collaboration and sharing of resources with many other countries in Asia, Africa and South America.
Research translation:
RHDAustralia was established in 2009 to support control and prevention initiatives for ARF and RHD in Australia. RHDA works alongsidehealth service providers, Aboriginal and Torres Strait Islander peoples, and other at risk populations, to reduce acute rheumatic fever and rheumatic heart disease in Australia, through the following activities:
- Updating, disseminating and integrating the 3rd edition of the Australian Guideline for the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease
- Developing and implementing high quality, evidence based education and training resources for health professionals, people with ARF/ RHD, their families and communities; and
- Supporting health systems to achieve evidence-based best practice for focused prevention activities in high-risk communities
For more information on the work being done by RHDA, please visit the website.
Key rheumatic heart disease staff:
- Professor Bart Currie, Director, RHDAustralia
- Associate Professor Anna Ralph, Clinical Director, RHDAustralia
- Dr Joshua Francis
- Dr Bo Remenyi
- Jessica de Dassel
- Melita McKinnon
- Alice Mitchell
- Emma Haynes
- Angela Kelly
- Leanne Hampshire
RHDAustralia staff:
- Professor Bart Currie, Director
- Associate Professor Anna Ralph, Clinical Director, RHDAustralia
- Bec Slade, Program Manager
- Eddie Masina, Indigenous Liaison Advisor
- Kenya McAdam, Indigenous Liaison Advisor
- Diana Mosca, Senior Nurse Advisor
- Sara Noonan, Technical Advisor
- Sean Rung, Communications and Project Support Officer
- Jill Thyne, Project Assistant
- Vicki Wade, Senior Cultural Advisor
- Pedriño Study
- On Track Watch (OTW): ‘A Grassroots Rheumatic Heart Disease Initiative in the Northern Territory’
- SP Plus: An expanded model of secondary prevention for individuals with rheumatic fever or rheumatic heart disease and their families
- Analysis of mortality trends for rheumatic heart disease (RHD) and rheumatic fever in Indigenous and non-Indigenous Australians
- Echocardiographic screening for RHD by nurses in Fiji – testing of a training module
- The global burden of disease study 2010: RHD writing group
- Reducing rheumatic fever and controlling RHD in Pacific Island Nations
- Improving delivery of secondary prophylaxis for RHD: a stepped-wedge, community-randomised trial
- RHDAustralia, national coordination unit for RHD
- RHD in pregnancy
- Evaluating the genetic contribution to RHD pathogenesis in Australian Aboriginal and Torres Strait Islander communities
- Identifying a unique inflammatory signature in ARF – a pilot study
- gECHO study (RHD screening study).
Click here to view rheumatic heart disease publications in PubMed.
RHDAustralia has developed a suite of educational resources, based on the Australian guideline for the prevention, diagnosis and management of ARF and RHD (2nd edition), for health professionals and communities. These can be accessed on the RHDAustralia website, along with a resource database of Australian ARF and RHD educational tools.
For the latest articles click here to be taken to the RHDAustralia news website.
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Research offers hope for rheumatic fever sufferers
Northern Territory data has been used to prove that timely treatment for people with rheumatic fever reduces the risk of recurring illness and death.
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Words from Arnhem land: Aboriginal health messages need to be made with us rather than for us
When researchers from Menzies School of Health Research starting working with us on rheumatic heart disease, we explained that the children needed better nutrition.
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Media Release|True burden of rheumatic fever in NZ currently underestimated, new research reveals
Media Release | University of Otago
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True burden of rheumatic fever in NZ underestimated
The joint study by researchers from the University of Otago, ESR, University of Auckland and the Menzies School of Health Research, Australia.
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Wire | RHD SCREENING CONTINUES
Health professionals and Maningrida stakeholders have come together to continue screenings of rheumatic heart disease (RHD).
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Wire | RHD SCREENING CONTINUES
Health professionals and Maningrida stakeholders have come together to continue screenings of rheumatic heart disease (RHD).
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Smart phones to help with remote area heart sickness
Dr Alice Mitchell is helping in the fight against one of the leading causes of death among young Indigenous people
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ABC | Rheumatic heart disease going undiagnosed by NT's fly-in doctors, cardiologist warns
The Northern Territory is home to some of the highest known rates of rheumatic heart disease in the world, but the transient nature of the region's medical practitioners could be hindering the fight to stop it.
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Arnhem Land children suffer world's highest known rates of rheumatic heart disease
In a remote Indigenous community of 3,000 people, researchers have discovered the highest known rates of rheumatic heart disease in the world, where children as young as four have died from the entirely preventable condition.
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Preventing RHD through community-driven activities
Health activities driven by remote Indigenous communities may be key to the sustainable and successful treatment and prevention of a potentially fatal disease, a study has found.
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Building genomics expertise in the NT
Menzies is investing and developing expertise in the emerging research area of genome sequencing. In the past year, we took the lead in a number of national and international collaborative programs investigating the genomics of tropical pathogens, and...
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Timorese Government prepares plan to prevent and combat rheumatic heart disease
The Timorese Ministry of Health is designing a prevention and diagnosis plan, part of the Family Health program, to combat rheumatic fever and rheumatic heart disease, the ministry's minister announced today.
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Saving Lives of remote children | NT News
Darwin researchers have uncovered alarming rates of rheumatic heart disease in East Timorese children.
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Cardiologists identify alarming levels of rheumatic heart disease in Timor-Leste
Research by Australian cardiologists has found the rates of rheumatic heart disease (RHD) in Timor-Leste are among the highest in the world. The landmark study was published in the Medical Journal of Australia.
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Sharing a Heartbeat: Rheumatic heart disease movie released in Darwin
A push for more awareness around the effects of rheumatic heart disease on pregnancy has led to a film developed, written, and directed by Australian Indigenous women.
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Rheumatic heart disease program in East Timor 'saving lives' with 'simple' penicillin injections
Australian doctors are working with East Timorese health workers to screen and treat children and young people with the illness, using methods similar to those used in Australia.
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Rheumatic heart disease: Preventable illness in Indigenous communities 'a national failure', AMA says
The Australian Medical Association has singled out a preventable disease caused by impoverished living conditions and untreated infections as Australia's "national failure".
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Launch of new e-learning modules to target world’s highest rate of rheumatic heart disease
RHDAustralia will launch 15 new ‘clinician e-learning modules’ at a seminar in Darwin as part of Australia’s Rheumatic Fever Strategy to tackle the world’s highest recorded rate of acute rheumatic fever and rheumatic heart disease.
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Seminar to reduce world’s highest rate of rheumatic heart disease in children
RHDAustralia will host a free seminar in Cairns tonight as part of Australia’s Rheumatic Fever Strategy to reduce the world’s highest recorded rate of acute rheumatic fever.
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Forum to forge path to end rheumatic heart disease
200 international leading experts and advocates for rheumatic heart disease will converge at the 3rd Global Rheumatic Heart Disease Forum in Melbourne next week.
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Call to arms to save children from rheumatic heart disease
A leading paediatric cardiologist has emphasised the need to prevent RHD in Indigenous children to avoid premature death, cardiac surgery and stroke to allow them to live a fulfilling life.
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Beating rheumatic heart disease: Experts converge in Darwin
Experts from around the country will meet in Darwin today at the RHD Australia Conference 2013: Practice and Culture to strengthen Australia’s fight to prevent rheumatic heart disease.
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Preventable disease leaves 13 year old with mechanical heart failure
RHD Australia will mark World Heart Day on 29 September by reminding people that rheumatic heart disease is preventable. Diagnosed at the age of seven, Carlisa Willika from the Werenbun community north of Katherine in the Northern Territory has lived with rheumatic heart disease for five years.