Aims:
  • To support Pacific Island nations to strengthen and develop Rheumatic Heart Disease (RHD) prevention activities while undertaking research to define and improve primary health care strategies, establish baseline epidemiology, and undertake screening.
Objectives:
  • To assist Ministries of Health in four Pacific Island Nations to develop new, or strengthen existing, RHD control programmes. The goal of this activity is to reduce death and disability caused by Acute Rheumatic Fever (ARF) in Pacific Island Nations.
Summary:

The project supports four Pacific Island countries to expand RHD control and prevention activities (Tuvalu and Nauru) and to commence RHD programmes (Kiribati and Solomon Islands). This work is based on a module that was developed by the World Heart Federation (WHF) Pacific and International programme working with Ministries of Health in Fiji, Samoa and Tonga over the past eight years.

The project has worked to establish baseline burden of disease data in the four countries, undertaking systematic case finding and echo screening of school children to determine prevalence. In addition the project has trained key staff in each country, developed national data bases and assists with health promotion and awareness activities.

Implications for policy and practice:

National RHD strategies and policies have been adopted by Ministries of Health in each country. The project team works with local staff to determine appropriate strategies and approaches to improve primary health management of known cases and to assist with early detection of new cases, to reduce the overall burden of RHD on the community and health systems. The core project team relies heavily on volunteer echo technologists and paediatric cardiologists from Australia and the Pacific region to undertake field screening activities.

Our research has found:

Following targeted case finding exercises and field echocardiography screening RHD prevalence data are now available for the school aged population in each of the four countries. The prevalence is Tuvalu school aged population is 45.5 /1000, in Nauru the prevalence was 36.6/1000, in Kiribati 20.6/1000 and in Solomon Islands 24/1000 for definite and borderline RHD. The project is currently working with each country to expand technical and training capacity to assist strengthening of RHD control.

Preliminary results are detailed in these posters - Nauru, Tuvalu, four countries.

Chief Investigator:
  • Samantha Colquhoun
Project Manager:
  • Liz Kennedy
 
Funders:

Four country project:

  • AusAID Pacific Public Health Sector Linkages Project.
Collaborators:
  • Solomon Islands Ministry of Health
  • Tuvalu Ministry of Health
  • Nauru Ministry of Health
  • Kiribati Ministry of Health
  • World Heart Federation
  • World Health Organisation
  • Secretariat of the Pacific Community
  • Centre for International Child Health, University of Melbourne
  • Telethon Child Health Research Institute
  • Cure Kids New Zealand
  • Fiji Ministry of Health and Fiji GrASP.
  1. Colquhoun, S.M., Carapetis, J.R., Kado, J.H., Steer, A.C. (2009). Rheumatic heart disease and its control in the Pacific. Expert Review of Cardiovascular Therapy, 7(12), 1517-24.
  2. Parks, T., Kado, J., Colquhoun, S., Carapetis, J., Steer, A. (2010). Underdiagnosis of acute rheumatic fever in primary care settings in a developing country. Tropical Medicine and International Health, 14(11), 1407-13.
  3. Steer, A.C., Colquhoun, S., Kado, J., Carapetis, J.R. (2011). Secondary prophylaxis is important for the prevention of recurrent rheumatic fever in the Pacific. Pediatric Cardiology, 32(6), 864-5.
  4. Steer, A., Colquhoun, S., Noonan, S., Kado, J., Viale, S., Carapetis, J. (2006). Control of rheumatic heart disease in the Pacific region. Pacific Health Dialogue, 13(2), 49-55.
  5. Steer, A.C., Kado, J., Colquhoun, S., Noonan, S., Babitu, T. (2006). Awareness of rheumatic heart disease. The Lancet, 367(9528), 2118
  6. Roberts, K.,Colquhoun, S., Steer, A., Remény,i B., Carapetis, J. (2012). Screening for rheumatic heart disease: current approaches and controversies. Nature Reviews Cardiology, 10(1), 49-58.