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Use of the Jones Criteria in the diagnosis of acute rheumatic fever in an Australian rural setting

Stewart, T., Mcdonald, R. and Currie, Bart J. (2005). Use of the Jones Criteria in the diagnosis of acute rheumatic fever in an Australian rural setting. Australian and New Zealand Journal of Public Health,29(6):526-529.

Document type: Journal Article
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IRMA ID 10139xPUB100
Title Use of the Jones Criteria in the diagnosis of acute rheumatic fever in an Australian rural setting
Author Stewart, T.
Mcdonald, R.
Currie, Bart J.
Journal Name Australian and New Zealand Journal of Public Health
Publication Date 2005
Volume Number 29
Issue Number 6
ISSN 1326-0200   (check CDU catalogue open catalogue search in new window)
Start Page 526
End Page 529
Total Pages 4
Place of Publication Australia
Publisher Wiley-Blackwell Publishing Asia
Field of Research 1117 - Public Health and Health Services
HERDC Category C1 - Journal Article (DEST)
Abstract Objective: To answer the question, are the Jones Criteria being used appropriately in the diagnosis of acute rheumatic fever (ARF) by non-specialist medical staff in a remote Australian setting? Methods: The medical records of all patients discharged from Katherine Hospital (Northern Territory) with a diagnosis of ARF between January 2000 and April 2004 were retrospectively reviewed for adherence to the Jones Criteria. Data were also collected on specialist follow-up and need for transfer to a tertiary hospital. Results: Twenty-five patients had a diagnosis of ARF and all were Aboriginal or Torres Strait Islander. Thirty-two per cent did not fulfil the Jones Criteria and of these 63% were recurrent cases. Eighty-eight per cent received specialist follow-up and of those who did not fulfil the Jones Criteria, all were diagnosed as ARF by the specialist. Only 20% required transfer to a tertiary hospital for higher-level care. Conclusion: The Jones Criteria are being used appropriately to diagnose initial episodes of ARF but less successfully in recurrent episodes. Specialist follow-up is essential but acute episodes can be managed in remote settings, reducing the need to transfer patients to tertiary care with resultant patient dislocation and social isolation. Implications: The diagnosis of ARF results in long-term penicillin prophylaxis. This is a major public health undertaking that requires correct diagnosis. This study demonstrates that the Jones Criteria are being used appropriately to diagnose ARF in a remote setting. The ability to diagnose and treat Indigenous patients within their local region reduces social isolation and creates a more positive health care experience.
Keywords acute
Australian
diagnosis
fever
rheumatic fever
Rural
DOI http://dx.doi.org/10.1111/j.1467-842X.2005.tb00244.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes 2862 (Journal)
 
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Created: Mon, 17 Dec 2007, 09:02:11 CST