Acute Rheumatic Fever and Rheumatic Heart Disease

Why are ARF and RHD an important priority for NACCHO?

Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) are entirely preventable conditions, and only occur in high income countries when the social and cultural determinants of health are not equitably addressed.

In Australia, Aboriginal and Torres Strait Islander people continue to be disproportionately affected by Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD). In 2022, the Australian Institute of Health and Welfare reported the number of cases of ARF and RHD increased nationally from 2016 – 2020, with 92% of ARF diagnoses occurring in Aboriginal and Torres Strait Islander people, and diagnoses of RHD 15 times more likely to occur than for non-Aboriginal and Torres Strait Islander people in the same time period.

What is ARF?

ARF occurs as an immunological response to a Group A Streptococcal (GAS) infection (be it of the skin or throat). People affected by ARF usually present with a range of non-specific symptoms and signs, including fever, painful and tender joints, rash, chest pain, shortness of breath, tiredness, and jerky body movements.

What is RHD?

RHD occurs when the heart valves are damaged by recurrent, untreated episodes of ARF. Whilst effective treatments exist to prevent people diagnosed with ARF from developing RHD, ARF is too often mis-diagnosed and mis-managed in Australia. Once the heart valves are permanently damaged, there is no cure. People affected by RHD require regular monitoring and follow-up, and may eventually require surgery to repair or replace the damaged heart valves. Lifelong medical check-ups and appropriate management are essential for every person living with RHD, to minimise any ongoing damage to the valves and heart muscle.

NACCHO’s ARF and RHD Program

Our Hearts in Our Hands

Our ARF and RHD Program marks the first-ever Aboriginal and Torres Strait Islander sector-led initiative to combat ARF and RHD across the country.

NACCHO provides funding to eligible ACCHOs to deliver ARF and RHD prevention and management activities in their communities. The limited funding available through the program is prioritised on a needs basis and targets ACCHOs in regions where there is a high incidence and prevalence of ARF and RHD. Participating ACCHOs join the ARF and RHD Community of Practice, a national network facilitated by NACCHO for primary health care workers with significant burdens of ARF and RHD.

A co-designed echocardiography training program is also being developed to strengthen the capacity of primary healthcare workers in the ACCHO sector to deliver community-led, evidence-based, culturally safe, equitable echocardiography services that better meets the needs of Aboriginal and Torres Strait Islander people at risk of, and living with, ARF and RHD.

The ARF and RHD program is supported by a sector-led national governance structure including a Rheumatic Fever Strategy Joint Advisory Committee, an RHD Expert Working Group and the Community of Practice.

The program is funded by the Australian Government, with additional investment from partners BHP and The Snow Foundation.

For more information about NACCHO’s ARF and RHD program, click here.

Would you like to learn more about ARF and RHD?

NACCHO’s RHD program resource library contains links to key publications and training modules that can be used by Aboriginal and Torres Strait Islander communities keen to prevent ARF and RHD. There are also resources for health professionals interested in learning more about the best ways to manage ARF and RHD. NACCHO is committed to making the resource library available to everyone, to help everyone in Community learn more about ARF and RHD – how to prevent it, how to identify it, how to treat and manage it, and also support people and families who are most affected.

Additional resources will be developed through NACCHO’s RHD program in collaboration with the ACCHO sector and added to this library over time.

If you have any questions, resource ideas or would like to share your own resources, please contact the RHD team at rhd@naccho.org.au.