Cargando…

Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia

Environmental factors including household crowding and inadequate washing facilities underpin recurrent streptococcal infections in childhood that cause acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD). No community-based ‘primordial’-level interventions to reduce streptococc...

Descripción completa

Detalles Bibliográficos
Autores principales: Ralph, Anna P., Kelly, Angela, Lee, Anne-Marie, Mungatopi, Valerina L., Babui, Segora R., Budhathoki, Nanda Kaji, Wade, Vicki, de Dassel, Jessica L., Wyber, Rosemary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407981/
https://www.ncbi.nlm.nih.gov/pubmed/36011846
http://dx.doi.org/10.3390/ijerph191610215
_version_ 1784774495814287360
author Ralph, Anna P.
Kelly, Angela
Lee, Anne-Marie
Mungatopi, Valerina L.
Babui, Segora R.
Budhathoki, Nanda Kaji
Wade, Vicki
de Dassel, Jessica L.
Wyber, Rosemary
author_facet Ralph, Anna P.
Kelly, Angela
Lee, Anne-Marie
Mungatopi, Valerina L.
Babui, Segora R.
Budhathoki, Nanda Kaji
Wade, Vicki
de Dassel, Jessica L.
Wyber, Rosemary
author_sort Ralph, Anna P.
collection PubMed
description Environmental factors including household crowding and inadequate washing facilities underpin recurrent streptococcal infections in childhood that cause acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD). No community-based ‘primordial’-level interventions to reduce streptococcal infection and ARF rates have been reported from Australia previously. We conducted a study at three Australian Aboriginal communities aiming to reduce infections including skin sores and sore throats, usually caused by Group A Streptococci, and ARF. Data were collected for primary care diagnoses consistent with likely or potential streptococcal infection, relating to ARF or RHD or related to environmental living conditions. Rates of these diagnoses during a one-year Baseline Phase were compared with a three-year Activity Phase. Participants were children or adults receiving penicillin prophylaxis for ARF. Aboriginal community members were trained and employed to share knowledge about ARF prevention, support reporting and repairs of faulty health-hardware including showers and provide healthcare navigation for families focusing on skin sores, sore throat and ARF. We hypothesized that infection-related diagnoses would increase through greater recognition, then decrease. We enrolled 29 participants and their families. Overall infection-related diagnosis rates increased from Baseline (mean rate per-person-year 1.69 [95% CI 1.10–2.28]) to Year One (2.12 [95% CI 1.17–3.07]) then decreased (Year Three: 0.72 [95% CI 0.29–1.15]) but this was not statistically significant (p = 0.064). Annual numbers of first-known ARF decreased, but numbers were small: there were six cases of first-known ARF during Baseline, then five, 1, 0 over the next three years respectively. There was a relationship between household occupancy and numbers (p = 0.018), but not rates (p = 0.447) of infections. This first Australian ARF primordial prevention study provides a feasible model with encouraging findings.
format Online
Article
Text
id pubmed-9407981
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94079812022-08-26 Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia Ralph, Anna P. Kelly, Angela Lee, Anne-Marie Mungatopi, Valerina L. Babui, Segora R. Budhathoki, Nanda Kaji Wade, Vicki de Dassel, Jessica L. Wyber, Rosemary Int J Environ Res Public Health Article Environmental factors including household crowding and inadequate washing facilities underpin recurrent streptococcal infections in childhood that cause acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD). No community-based ‘primordial’-level interventions to reduce streptococcal infection and ARF rates have been reported from Australia previously. We conducted a study at three Australian Aboriginal communities aiming to reduce infections including skin sores and sore throats, usually caused by Group A Streptococci, and ARF. Data were collected for primary care diagnoses consistent with likely or potential streptococcal infection, relating to ARF or RHD or related to environmental living conditions. Rates of these diagnoses during a one-year Baseline Phase were compared with a three-year Activity Phase. Participants were children or adults receiving penicillin prophylaxis for ARF. Aboriginal community members were trained and employed to share knowledge about ARF prevention, support reporting and repairs of faulty health-hardware including showers and provide healthcare navigation for families focusing on skin sores, sore throat and ARF. We hypothesized that infection-related diagnoses would increase through greater recognition, then decrease. We enrolled 29 participants and their families. Overall infection-related diagnosis rates increased from Baseline (mean rate per-person-year 1.69 [95% CI 1.10–2.28]) to Year One (2.12 [95% CI 1.17–3.07]) then decreased (Year Three: 0.72 [95% CI 0.29–1.15]) but this was not statistically significant (p = 0.064). Annual numbers of first-known ARF decreased, but numbers were small: there were six cases of first-known ARF during Baseline, then five, 1, 0 over the next three years respectively. There was a relationship between household occupancy and numbers (p = 0.018), but not rates (p = 0.447) of infections. This first Australian ARF primordial prevention study provides a feasible model with encouraging findings. MDPI 2022-08-17 /pmc/articles/PMC9407981/ /pubmed/36011846 http://dx.doi.org/10.3390/ijerph191610215 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ralph, Anna P.
Kelly, Angela
Lee, Anne-Marie
Mungatopi, Valerina L.
Babui, Segora R.
Budhathoki, Nanda Kaji
Wade, Vicki
de Dassel, Jessica L.
Wyber, Rosemary
Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia
title Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia
title_full Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia
title_fullStr Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia
title_full_unstemmed Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia
title_short Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia
title_sort evaluation of a community-led program for primordial and primary prevention of rheumatic fever in remote northern australia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407981/
https://www.ncbi.nlm.nih.gov/pubmed/36011846
http://dx.doi.org/10.3390/ijerph191610215
work_keys_str_mv AT ralphannap evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT kellyangela evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT leeannemarie evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT mungatopivalerinal evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT babuisegorar evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT budhathokinandakaji evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT wadevicki evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT dedasseljessical evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia
AT wyberrosemary evaluationofacommunityledprogramforprimordialandprimarypreventionofrheumaticfeverinremotenorthernaustralia