The evidence that rheumatic heart disease control programs in Australia are making an impact

Ingrid Stacey; Anna Ralph; Jessica de Dassel; Lee Nedkoff; Vicki Wade; Carl Francia; Rosemary Wyber; Kevin Murray; Joseph Hung; Judith Katzenellenbogen

doi:10.1016/j.anzjph.2023.100071

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The evidence that rheumatic heart disease control programs in Australia are making an impact

Journal article

Open access

Peer reviewed

The evidence that rheumatic heart disease control programs in Australia are making an impact

Ingrid Stacey, Anna Ralph, Jessica de Dassel, Lee Nedkoff, Vicki Wade, Carl Francia, Rosemary Wyber, Kevin Murray, Joseph Hung and Judith Katzenellenbogen

Australian and New Zealand journal of public health, Vol.47(4), 100071

2023

DOI: https://doi.org/10.1016/j.anzjph.2023.100071

PMID: 37364309

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Abstract

acute rheumatic fever

cardiovascular epidemiology

control programs

disease progression

indigenous health

rheumatic heart disease

Objective Rheumatic heart disease (RHD) comprises heart-valve damage caused by acute rheumatic fever (ARF). The Australian Government Rheumatic Fever Strategy funds RHD Control Programs to support detection and management of ARF and RHD. We assessed epidemiological changes during the years of RHD Control Program operation. Methods Linked RHD register, hospital and death data from four Australian jurisdictions were used to measure ARF/RHD outcomes between 2010 and 2017, including: 2-year progression to severe RHD/death; ARF recurrence; secondary prophylaxis delivery and earlier disease detection. Results Delivery of secondary prophylaxis improved from 53% median proportion of days covered (95%CI: 46-61%, 2010) to 70% (95%CI: 71-68%, 2017). Secondary prophylaxis adherence protected against progression to severe RHD/death (hazard ratio 0.2, 95% CI 0.1-0.8). Other measures of program effectiveness (ARF recurrences, progression to severe RHD/death) remained stable. ARF case numbers and concurrent ARF/RHD diagnoses increased. Conclusions RHD Control Programs have contributed to major success in the management of ARF/RHD through increased delivery of secondary prevention yet ARF case numbers, not impacted by secondary prophylaxis and sensitive to increased awareness/surveillance, increased. Implications for public health RHD Control Programs have a major role in delivering cost-effective RHD prevention. Sustained investment is needed but with greatly strengthened primordial and primary prevention.

Details

Title: The evidence that rheumatic heart disease control programs in Australia are making an impact
Authors/Creators: Ingrid Stacey - The University of Western Australia
Anna Ralph - Royal Darwin Hospital
Jessica de Dassel - Northern Health
Lee Nedkoff - The University of Western Australia
Vicki Wade - National Heart Foundation of Australia
Carl Francia - Prince Charles Hospital
Rosemary Wyber - Australian Institute of Aboriginal and Torres Strait Islander Studies
Kevin Murray - The University of Western Australia
Joseph Hung - The University of Western Australia
Judith Katzenellenbogen - The Kids Research Institute Australia
Publication Details: Australian and New Zealand journal of public health, Vol.47(4), 100071
Publisher: Elsevier B.V
Grant note: ARF
Identifiers: 991005884940607891
Murdoch Affiliation: Ngangk Yira Institute for Change
Language: English
Resource Type: Journal article

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