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Research

Reach: to stop rheumatic heart disease

Reach works to promote the health of vulnerable populations by providing technical support to local, regional and global efforts to prevent and control rheumatic fever and rheumatic heart disease (RF/RHD).

Research

Missed Opportunities for Diagnosing Acute Rheumatic Fever

We have read with interest the new publication by Rouhiainen and colleagues on missed opportunities for preventing or diagnosing acute rheumatic fever (ARF).

Research

Topical antibiotics for chronic suppurative otitis media

Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media, is a chronic inflammation and often polymicrobial infection (involving more than one micro-organism) of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane.

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What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian health care

This review aims to systematically identify contextual and mechanistic factors that contribute to the success or failure of implementing effective HCs in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care (PHC).

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Population pharmacokinetics of penicillin G: insights into increased clearance at low concentrations to guide development of improved long-acting formulations for syphilis

Although benzylpenicillin (penicillin G) is listed by the World Health Organization as an Essential Medicine, dose optimization is a persistent challenge, especially for long-acting intramuscular formulations. Maintaining sustained antibiotic exposure at target concentrations is crucial for secondary chemoprophylaxis of rheumatic heart disease and treatment of syphilis. 

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Longitudinal surveillance of group A streptococcal pharyngitis and impetigo in remote Western Australian school children informs acute rheumatic fever prevention

The prevalence of impetigo and pharyngitis - which are both superficial group A streptococcus (GAS) infections that precede acute rheumatic fever - is poorly defined. Guidelines recommend the early diagnosis of both infections to prevent ARF; however, screening to enable the concurrent detection of these infections in high-risk populations has rarely been performed. 

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Koolungar (Children) Moorditj (Strong) Healthy Skin Project Part II: Skin Health in Urban-Living Australian Aboriginal Children

Although essential for overall health and wellbeing, little is known about skin health in urban-living Australian Aboriginal children. This co-designed, research-service project aimed to describe skin health and document skin disease frequency in urban-living Aboriginal children and young people in Western Australia and investigate housing associations for skin infections.

Research

It’s not just droplets: a systematic review and meta-analysis of the modes of transmission of Group A Streptococcus

The transmission of Group A Streptococcus (Strep A) through respiratory droplets has been considered the dominant mode of transmission to date; however, little is known about the relative contribution of other modes of transmission. This review systematically summarises the contemporary evidence regarding the transmission of Strep A.

Research

Clinical decision rules for diagnosis of Streptococcus pyogenes sore throat in Fiji: a prospective diagnostic accuracy study

Acute rheumatic fever is an immune-mediated condition triggered by Streptococcus pyogenes sore throat and possibly skin infection, with a substantial burden in resource-limited settings. Clinical decision rules (CDRs) are commonly used to guide antibiotic treatment of sore throat based on signs and symptoms, but their diagnostic accuracy varies by study and setting. This work aimed to assess the accuracy of multiple CDRs in Fiji to diagnose S. pyogenes sore throat.

Research

Subcutaneous infusion of high-dose benzathine penicillin G is safe, tolerable, and suitable for less-frequent dosing for rheumatic heart disease secondary prophylaxis: a phase 1 open-label population pharmacokinetic study

Since 1955, the recommended strategy for rheumatic heart disease secondary prophylaxis has been benzathine penicillin G injections administered intramuscularly every 4 weeks. Due to dosing frequency, pain, and programmatic challenges, adherence is suboptimal. It has previously been demonstrated that BPG delivered subcutaneously at a standard dose is safe and tolerable and has favorable pharmacokinetics, setting the scene for improved regimens with less frequent administration.