BACKGROUND: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) contribute to Aboriginal Australian and Torres Strait Islander health disadvantage. At the time of this study, specialist ARF/RHD care in the Kimberley region of Western Australia was delivered by a broad range of providers. In contrast, in Far North Queensland (FNQ), a single-provider model was used as part of a coordinated RHD control programme. AIMS: To review ARF/RHD management in the Kimberley and FNQ to ascertain whether differing models of service delivery are associated with different disease burden and patient care. METHODS: An audit of ARF/RHD management. Classification and clinical management data were abstracted from health records, specialist letters, echocardiograms and regional registers using a standardised data collection tool. RESULTS: Four hundred and seven patients were identified, with 99% being Aboriginal and/or Torres Strait Islanders. ARF without RHD was seen in 0.4% of Aboriginal and/or Torres Strait Islander residents and RHD in 1.1%. The prevalence of RHD was similar in both regions but with more severe disease in the Kimberley. More FNQ RHD patients had specialist review within recommended time frames (67% vs 45%, χ(2) , P < 0.001). Of patients recommended benzathine penicillin secondary prophylaxis, 17.7% received ≥80% of scheduled doses in the preceding 12 months. Prescription and delivery of secondary prophylaxis was greater in FNQ. CONCLUSIONS: FNQ's single-provider model of specialist care and centralised RHD control programme were associated with improved patient care and may partly account for the fewer cases of severe disease and reduced surgical procedures and other interventions observed in this region.
BACKGROUND: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) contribute to Aboriginal Australian and Torres Strait Islander health disadvantage. At the time of this study, specialist ARF/RHD care in the Kimberley region of Western Australia was delivered by a broad range of providers. In contrast, in Far North Queensland (FNQ), a single-provider model was used as part of a coordinated RHD control programme. AIMS: To review ARF/RHD management in the Kimberley and FNQ to ascertain whether differing models of service delivery are associated with different disease burden and patient care. METHODS: An audit of ARF/RHD management. Classification and clinical management data were abstracted from health records, specialist letters, echocardiograms and regional registers using a standardised data collection tool. RESULTS: Four hundred and seven patients were identified, with 99% being Aboriginal and/or Torres Strait Islanders. ARF without RHD was seen in 0.4% of Aboriginal and/or Torres Strait Islander residents and RHD in 1.1%. The prevalence of RHD was similar in both regions but with more severe disease in the Kimberley. More FNQ RHDpatients had specialist review within recommended time frames (67% vs 45%, χ(2) , P < 0.001). Of patients recommended benzathine penicillin secondary prophylaxis, 17.7% received ≥80% of scheduled doses in the preceding 12 months. Prescription and delivery of secondary prophylaxis was greater in FNQ. CONCLUSIONS: FNQ's single-provider model of specialist care and centralised RHD control programme were associated with improved patient care and may partly account for the fewer cases of severe disease and reduced surgical procedures and other interventions observed in this region.
Authors: Liesl Zühlke; Mark E Engel; Ganesan Karthikeyan; Sumathy Rangarajan; Pam Mackie; Blanche Cupido; Katya Mauff; Shofiqul Islam; Alexia Joachim; Rezeen Daniels; Veronica Francis; Stephen Ogendo; Bernard Gitura; Charles Mondo; Emmy Okello; Peter Lwabi; Mohammed M Al-Kebsi; Christopher Hugo-Hamman; Sahar S Sheta; Abraham Haileamlak; Wandimu Daniel; Dejuma Y Goshu; Senbeta G Abdissa; Araya G Desta; Bekele A Shasho; Dufera M Begna; Ahmed ElSayed; Ahmed S Ibrahim; John Musuku; Fidelia Bode-Thomas; Basil N Okeahialam; Olukemi Ige; Christopher Sutton; Rajeev Misra; Azza Abul Fadl; Neil Kennedy; Albertino Damasceno; Mahmoud Sani; Okechukwu S Ogah; Taiwo Olunuga; Huda H M Elhassan; Ana Olga Mocumbi; Abiodun M Adeoye; Phindile Mntla; Dike Ojji; Joseph Mucumbitsi; Koon Teo; Salim Yusuf; Bongani M Mayosi Journal: Eur Heart J Date: 2014-11-25 Impact factor: 29.983
Authors: Rosemary Wyber; Ben J Boyd; Samantha Colquhoun; Bart J Currie; Mark Engel; Joseph Kado; Ganesan Karthikeyan; Mark Sullivan; Anita Saxena; Meru Sheel; Andrew Steer; Joseph Mucumbitsi; Liesl Zühlke; Jonathan Carapetis Journal: Drug Deliv Transl Res Date: 2016-10 Impact factor: 4.617
Authors: E Anne Russell; Lavinia Tran; Robert A Baker; Jayme S Bennetts; Alex Brown; Christopher M Reid; Robert Tam; Warren F Walsh; Graeme P Maguire Journal: BMC Cardiovasc Disord Date: 2015-09-23 Impact factor: 2.298
Authors: Elizabeth Anne Russell; Lavinia Tran; Robert A Baker; Jayme S Bennetts; Alex Brown; Christopher Michael Reid; Robert Tam; Warren Frederick Walsh; Graeme Paul Maguire Journal: BMC Cardiovasc Disord Date: 2014-10-02 Impact factor: 2.298
Authors: Jennifer Chamberlain-Salaun; Jane Mills; Priya M Kevat; Marc G W Rémond; Graeme P Maguire Journal: BMC Cardiovasc Disord Date: 2016-08-31 Impact factor: 2.298