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Rheumatic Heart Disease Endgame Strategy: what does it mean to community?

Across Australia, more than 5,000 Aboriginal and Torres Strait Islander people are currently living with rheumatic heart disease (RHD) or its precursor, acute rheumatic fever (ARF).

Visit from On Track Watch Community Researchers helps build a pathway of looking at two different cultures

For Aboriginal Community Researchers Minitja Marawili and Yunutju Gondarra, the work of the END RHD CRE is deeply personal.

Laqueisha's story: living with RHD

Laqueisha was just five years old when she was diagnosed with rheumatic heart disease and sent on a 5,000km return trip to Perth for major heart surgery.

Longitudinal surveillance of group A streptococcal pharyngitis and impetigo in remote Western Australian school children informs acute rheumatic fever prevention

The prevalence of impetigo and pharyngitis - which are both superficial group A streptococcus (GAS) infections that precede acute rheumatic fever - is poorly defined. Guidelines recommend the early diagnosis of both infections to prevent ARF; however, screening to enable the concurrent detection of these infections in high-risk populations has rarely been performed. 

The value of molecular point-of-care testing for Group A Streptococcal pharyngitis in a remote, non-clinical Australian setting

Group A Streptococcal (GAS) pharyngitis is an important precursor infection to severe complications including rheumatic fever and invasive GAS. Rapid molecular point of care testing (POCT) for GAS infection has advantages over traditional microbiological culture, especially in settings with limited or absent laboratory infrastructure and where GAS complications predominate.

Missed Opportunities for Diagnosing Acute Rheumatic Fever

We have read with interest the new publication by Rouhiainen and colleagues on missed opportunities for preventing or diagnosing acute rheumatic fever (ARF).

Severe adverse reactions to benzathine penicillin G in rheumatic heart disease: A systematic review and meta-analysis

Fear of severe adverse reaction (SAR) and reluctance of health care providers to administer intramuscular injections are major contributing factors to poor adherence of benzathine penicillin G (BPG) in the management of rheumatic heart disease (RHD). However, data on the risk of SARs following BPG injections for RHD are relatively limited and inconclusive. Our systematic review and meta-analysis aimed to evaluate the incidence of SARs associated with BPG injections used for secondary prophylaxis of RHD. 

Population pharmacokinetics of penicillin G: insights into increased clearance at low concentrations to guide development of improved long-acting formulations for syphilis

Although benzylpenicillin (penicillin G) is listed by the World Health Organization as an Essential Medicine, dose optimization is a persistent challenge, especially for long-acting intramuscular formulations. Maintaining sustained antibiotic exposure at target concentrations is crucial for secondary chemoprophylaxis of rheumatic heart disease and treatment of syphilis. 

Stakeholders Want a Menu of Choices: Findings from a Consultation Workshop on Improving Access to Secondary Prophylaxis of Rheumatic Fever and Rheumatic Heart Disease

Intramuscular (IM) injection of benzathine benzylpenicillin G (BPG) forms the cornerstone of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) secondary prophylaxis. BPG is available as either a low-cost powdered formulation or a costlier pre-filled suspension. Most of the global RHD burden lies in low- and middle-income countries, which rely on the powdered formulation.