1. RHEUMATIC HEART DISEASE
Kathy Brown
Senior Director
Aboriginal and Torres Strait Islander Health Branch
Queensland Health
RHEUMATIC HEART DISEASE
A plan of action for Queensland
“While acute rheumatic fever has become a rare curiosity in Australia’s non-Indigenous population, its incidence in Indigenous Australians living in remote areas remains among the highest reported in the world. It is unlikely that such a stark contrast between two populations living within the same national borders exists for any other disease or on any other continent.”
– Alex Brown, Malcolm McDonald, Tom Calma

2. The Rheumatic Heart Disease pathway
Diagnosis should be based on assessment of symptoms combined with clinical history.
Rheumatic Heart Disease occurs when untreated, recurrent ARF episodes cause heart valve damage.
Recurrence rate of ARF is greatest in first year after first episode.
Social determinants such as poor living conditions are key drivers for onset of ARF and RHD.
Acute Rheumatic Fever is an autoimmune response to a group A streptococcus (GAS) bacterial infection.
Misdiagnosis occurs due to complexity of diagnosis may result in delayed or no treatment.
Symptoms such as fever, joint pain, sore throats and rashes are non-specific to the infection.

3. Queensland CVD Burden by condition, age and Indigenous status (2011)
Acute Rheumatic Fever and Rheumatic Heart Disease in Queensland
Queensland CVD Burden by condition, age and Indigenous status (2011)
88 percent
The proportion of ARF notifications (total 1,151) for Indigenous Queenslanders (1,018) between 1999 and 2017
12 years
The median age for onset of ARF for both Indigenous and non-Indigenous Queenslanders
RHD Register data
Indigenous
Non-Indigenous
169 times
The prevalence rate of RHD for Indigenous Australians compared with non-Indigenous Australians
at December 2015
1,055
The number of Indigenous Queenslanders with RHD currently listed on the Queensland RHD Register
at July 2017

4. National Queensland Rheumatic Heart Policy Framework
Rheumatic Fever Strategy (2009) – State-based register and control programs; education and training resources; data collection.
Evaluation of the RHS (2017) – Support an increased awareness of ARF and RHD among Aboriginal and Torres Strait Islander Queenslanders.
National Partnership Agreement on Rheumatic Fever Strategy ( ) – Commonwealth funding continued for three years (2017–18 to 2020–21).
Queensland
Queensland RHD Register and Control Program – State-based register and recall system, improved clinical care, education and training, data collection.
Queensland Aboriginal and Torres Strait Islander Rheumatic Heart Disease Action Plan 2018–2021

5. $4.5 million (over 3 years from 2018-19)
Rheumatic Heart Disease Action Plan
$4.5 million (over 3 years from )
New funding has been earmarked for activities under the RHD Action Plan:
Support an increased awareness of ARF and RHD among Aboriginal and Torres Strait Islander Queenslanders
Increased education for communities and clinicians on identifying the early symptoms of ARF and the important of early treatment
Foster clinical knowledge on ARF and RHD across the health workforce, to support early diagnosis and treatment
Enhance the Queensland RHD Register and Control Program to enable stronger linkages with acute cardiology services.

6. Priorities under the RHD Action Plan
Promote, prevent, empower
Ensure patients have the information they need and enable them to make the best decisions on their health.
Improve the patient experience
Provide patients with a comfortable clinical experience, coordinated streamlined service delivery and positive engagement with health care providers.
Strengthen the approach
Work cohesively to establish new relationships and partnerships with health service providers, and build on existing ones.
Foster clinical knowledge
Enable health professionals to appropriately prevent, diagnose and manage ARF and RHD.
Enhance the Queensland RHD Register and Control Program
Enable the Register to fully meet the needs of patients, other stakeholders and the requirements of the Rheumatic Fever Strategy and the Action Plan.

7. Questions?