Ending rheumatic heart disease in Aboriginal and Torres Strait Islander communities: A systematic review of prevention programs in Australia

Article

Cai, Yumeng, Delaney, Lori J., Lynch, Debby, Cunninghame, Jacqueline, Takashima, Mari, Ullman, Amanda, Toombs, Maree, Martin, Antonella, Thompson, Kate, Maxwell, Karina, Moore, Jane, Kilgour, Catherine and Holland, Lorelle. 2025. "Ending rheumatic heart disease in Aboriginal and Torres Strait Islander communities: A systematic review of prevention programs in Australia ." First Nations Health and Wellbeing - The Lowitja Journal. 3. https://doi.org/10.1016/j.fnhli.2024.100040
Article Title

Ending rheumatic heart disease in Aboriginal and Torres Strait Islander communities: A systematic review of prevention programs in Australia

Article CategoryArticle
AuthorsCai, Yumeng, Delaney, Lori J., Lynch, Debby, Cunninghame, Jacqueline, Takashima, Mari, Ullman, Amanda, Toombs, Maree, Martin, Antonella, Thompson, Kate, Maxwell, Karina, Moore, Jane, Kilgour, Catherine and Holland, Lorelle
Journal TitleFirst Nations Health and Wellbeing - The Lowitja Journal
Journal Citation3
Article Number100040
Number of Pages24
Year2025
PublisherElsevier
Place of PublicationNetherlands
ISSN2949-8406
Digital Object Identifier (DOI)https://doi.org/10.1016/j.fnhli.2024.100040
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S2949840624000317
Abstract

Purpose
Australia has one of the highest incidences of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in the world, with a disproportionate disease burden on Aboriginal and Torres Strait Islander communities. This systematic review aimed to explore the effectiveness and cultural responsiveness of prevention programs to prevent, reduce and control RHD, to improve quality of life, and prioritise community engagement and empowerment.
Methods
A systematic review was conducted involving a comprehensive search of three databases (PubMed, Embase and CINAHL) and grey literature from Australian Indigenous websites and Google Scholar. Articles met inclusion criteria if they evaluated prevention programs, targeted ARF/RHD and centred Aboriginal and Torres Strait Islander communities in Australia. Data were extracted by three reviewers, and results were descriptively analysed. Study quality was appraised via the Mixed Methods Appraisal Tool and the Aboriginal and Torres Strait Islander Quality Appraisal Tool.
Main findings
Eleven peer reviewed articles were included. Prevention programs varied in their effectiveness and cultural responsiveness to reduce ARF and RHD. Overall, the studies scored higher for generalised methodological quality determined by the Mixed Methods Appraisal Tool than the measurement of cultural responsiveness via the Aboriginal and Torres Strait Islander Quality Appraisal Tool. Research engagement with Aboriginal and Torres Strait Islander communities addressed ways to improve screening strategies to identify ARF, awareness of RHD adherence to penicillin prophylaxis, community-led education and training, environmental health and community-centred traditional language to convey culturally responsive health messaging.
Principal conclusions
Further research is urgently needed in the provision of effective and culturally responsive prevention programs to reduce the incidence of ARF and RHD. Studies that centre Indigenous-led and community-based prevention programs that value self-determination, community agency and autonomy to advance holistic health and wellbeing for Aboriginal and Torres Strait Islander peoples offer promise in the elimination of ARF and RHD.

KeywordsAcute rheumatic fever; Rheumatic heart disease; Community-based programs; Decolonising paradigms; Indigenous health; Health equity
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 20204205. Nursing
Byline AffiliationsUniversity of Queensland
Children’s Health Queensland Hospital and Health Service, Queensland
University of New South Wales
Sunrise Health Service Aboriginal Corporation, Australia
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