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An Australian guideline for rheumatic fever and rheumatic heart disease: an abridged outline

Carapetis, Jonathan R., Brown, Alex, Wilson, Nigel J. and Edwards, Keith N. (2007). An Australian guideline for rheumatic fever and rheumatic heart disease: an abridged outline. Medical Journal of Australia,186(11):581-586.

Document type: Journal Article
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Title An Australian guideline for rheumatic fever and rheumatic heart disease: an abridged outline
Author Carapetis, Jonathan R.
Brown, Alex
Wilson, Nigel J.
Edwards, Keith N.
Journal Name Medical Journal of Australia
Publication Date 2007
Volume Number 186
Issue Number 11
ISSN 0025-729X   (check CDU catalogue open catalogue search in new window)
Start Page 581
End Page 586
Total Pages 6
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C1 - Journal Article (DEST)
Abstract Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are diseases of poverty. They occur at world-record rates in Indigenous Australians, yet individual cases are often poorly managed, and most jurisdictions with high rates of these diseases do not have formal control strategies in place.

New Australian guidelines formulated in 2005 by the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand for diagnosis and management of ARF and RHD are a valuable resource for clinicians and policymakers.

Key recommendations of the guidelines include:

•New diagnostic criteria for ARF in high-risk populations, including Indigenous Australians, which include echocardiographic evidence of subclinical valvular disease, and polyarthralgia or aseptic monoarthritis as major manifestations.
•Clear guidance about treatment of ARF. Non-steroidal anti-inflammatory drugs should be withheld until the diagnosis is confirmed, and corticosteroids may be an option in severe acute carditis. Most cases of chorea do not require medication, but use of carbamazepine or sodium valproate is recommended if medication is needed.
•Clear guidance about dose, dosing frequency and duration of secondary prophylaxis. Benzathine penicillin G is the preferred medication for this purpose.
•Establishment of a coordinated control program for all regions of Australia where there are populations with high prevalence of ARF and RHD. Key elements and indicators for evaluation are recommended.
•Active screening and legislated notification of ARF and RHD, where possible.
•Development of a structured care plan for all patients with a history of ARF or with established RHD, to be recorded in the patient’s primary health care record.

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