Reports and Findings
Research
Disparity in Mortality From Rheumatic Heart Disease in Indigenous AustraliansIndigenous Australians are much more likely to die from Rheumatic Heart Disease than other Australians.
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Rheumatic heart disease in Indigenous young peoplesIndigenous children and young peoples live with an inequitable burden of acute rheumatic fever and rheumatic heart disease. In this Review, we focus on the epidemiological burden and lived experience of these conditions for Indigenous young peoples in Australia, New Zealand, and Canada. We outline the direct and indirect drivers of rheumatic heart disease risk and their mitigation.
Research
Primary prevention of acute rheumatic feverAcute rheumatic fever (ARF) is an abnormal immune reaction following Streptococcus pyogenes (Strep A) infection of the throat, and likely the skin. Primary prevention is the prompt and appropriate antibiotic treatment of Strep A infection, and it can reduce the risk of developing ARF and subsequent rheumatic heart disease.
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Working Towards a Better Understanding of ARFGoal: Characterize the pattern of contemporary and endemic ARF and develop a biological signature to improve sensitivity and specificity of ARF diagnosis.
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A controlled human infection model of Streptococcus pyogenes pharyngitis (CHIVAS-M75): an observational, dose-finding studyStreptococcus pyogenes is a leading cause of infection-related morbidity and mortality. A reinvigorated vaccine development effort calls for new clinically relevant human S pyogenes experimental infection models to support proof of concept evaluation of candidate vaccines. We describe the initial Controlled Human Infection for Vaccination Against S pyogenes (CHIVAS-M75) study, in which we aimed to identify a dose of emm75 S pyogenes that causes acute pharyngitis in at least 60% of volunteers when applied to the pharynx by swab.
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Repeat pneumococcal polysaccharide vaccine in Indigenous Australian adults is associated with decreased immune responsivenessThese findings highlight the critical need to evaluate the efficacy of future pneumococcal vaccine programs in the Australian Indigenous populations that recommend repeated doses of 23vPPV.
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Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal communityWe report the impact on Strongyloides seroprevalence after two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community.
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Initiating an undiagnosed diseases program in the Western Australian public health systemWe describe the initiation and summary outcomes of a public health system approach for complex undiagnosed patients- the Undiagnosed Diseases Program - WA
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Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world.
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Clinical development strategy for a candidate group A streptococcal vaccineThis review outlines a clinical development strategy detailing the phases of development required for registration of a candidate Group A streptococci vaccin
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Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi‐State ModelThe prognosis of young Indigenous Australians diagnosed with severe RHD is bleak; interventions must focus on earlier detection and treatment
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Echocardiographic screening for rheumatic heart disease in indigenous Australian children: A cost-utility analysisEchocardiographic screening for rheumatic heart disease is cost-effective in our context
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Structured review of primary interventions to reduce group A streptococcal infections, acute rheumatic fever and rheumatic heart diseaseRheumatic heart disease (RHD) is a large, preventable, global public health burden. In New Zealand (NZ), acute rheumatic fever (ARF) and RHD rates are highest for Māori and Pacific children. This structured review explores the evidence for primary prevention interventions to diagnose and effectively treat group A Streptococcus (GAS) pharyngitis and skin infections to reduce rates of ARF and RHD.
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Modes of transmission and attack rates of group A Streptococcal infection: a protocol for a systematic review and meta-analysisSummarising the current knowledge of Strep A transmission to humans will address gaps in the evidence and inform prevention and control strategies. The objective of this study is to evaluate the modes of transmission and attack rates of group A streptococcal infection in human populations.
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Clinical Evaluation and Diagnosis of Acute Rheumatic FeverThe diagnosis of acute rheumatic fever relies on a combination of clinical evaluation and laboratory studies. Diagnosis is usually made using the Jones criteria, which have recently been updated in 2015.
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The economic and health burdens of diseases caused by group A Streptococcus in New ZealandIn preparation for the future arrival of a group A Streptococcus (GAS) vaccine, this study estimated the economic and health burdens of GAS diseases in New Zealand. The annual incidence of GAS diseases was based on extrapolation of the average number of primary healthcare episodes managed each year in general practices (2014-2016) and on the average number of hospitalizations occurring each year (2005-2014). Disease incidence was multiplied by the average cost of diagnosing and managing an episode of disease at each level of care to estimate the annual economic burden.
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Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018-2019Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division's referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes.
Research
Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 StudyCardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.