Search is on for rheumatic test tool

Prof Jonathan Carapetis and Kenya McAdams.

Australian researchers are working on a way to diagnose acute rheumatic fever and prevent the life-threatening rheumatic heart disease that disproportionately affects Indigenous Australians.

The research was made possible by $2 million grant from the National Health and Medical Research Council to Perth’s Telethon Kids Institute and Darwin’s Menzies School of Health Research.

Led by institute director Professor Jonathan Carapetis, the new study will use cutting-edge technology to test samples from people with ARF, looking for combinations of markers that could turn into a diagnostic test and allow preventative treatment to take place.

“RHD is the most common cardiovascular disease in children and young adults globally, and in Australia it is arguably the starkest example of the health gap between young Indigenous and non-Indigenous people,” Prof Carapetis said.

“There are currently close to 3000 people with ARF or RHD registered in the Northern Territory, and young Indigenous Australians in the Territory are up to 122 times more likely to have RHD than their non-Indigenous counterparts.

“It is caused by a bacterial infection of the throat and skin, which, without treatment with antibiotics, can result in heart failure and other complications including stroke.

“We have found that up to 50 per cent of Indigenous patients already have established RHD at their first diagnosis, and this is because earlier episodes of ARF were missed.

“One of the reasons is that the diagnosis can be difficult to make, so a diagnostic test would be a real breakthrough.

“Catching RHD in the early stages is essential as the consequences have major long-terms effects – children must travel for heart surgery, young adults live with premature disability, and pregnant women face high-risk pregnancies.

“If we can diagnose it at its earliest stages, then prevention treatment with penicillin can be started, which can stop RHD developing or worsening.”
The study involves researchers from around Australia, New Zealand and Singapore, with the majority of study participants recruited from Darwin and Alice Springs.

According to RHD Australia, almost all cases of rheumatic fever recorded in the NT between 2005 and 2010 were for Aboriginal and Torres Strait Islander people.

Aboriginal people are 69 times more likely than non-Aboriginal people to develop rheumatic fever and 64 times more likely to have rheumatic heart disease.

Between 2007 and 2009, 897 deaths were attributed to rheumatic heart disease.

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