CM Health team’s trailblazing approach to combating rheumatic heart disease

Latest News 9 December 2020 | A Counties Manukau Health team led by paediatric infectious diseases specialist, Dr Rachel Webb, will develop and test an all-new approach for the early detection of rheumatic heart disease as part of a suite of new research to be carried out by some of New Zealand’s district health boards.

Made possible by the Health Research Council of New Zealand’s new Health Sector Research Collaboration Grants, Dr Webb says the new nurse-led approach for offering echocardiograms (heart scans) to siblings of children recently diagnosed with acute rheumatic fever (ARF) at Kidz First Children’s Hospital may go some way towards addressing health workforce shortages and improving rheumatic fever services in Counties Manukau.

“The training of nurse sonographers for rheumatic heart disease is a first for New Zealand,” she says.

“Counties Manukau experiences the highest burden of acute rheumatic fever and chronic rheumatic heart disease of any region in New Zealand, with almost all cases occurring among Maaori and Pacific peoples, and we all share an urgent responsibility to address this inequitable and unacceptable situation.”

Evidence shows siblings of ARF patients have approximately three times the increased risk of rheumatic heart disease - a serious condition that can follow on from acute rheumatic fever and have devastating impacts on long-term health and wellbeing - compared to children in families where no one else is affected, yet siblings are not currently offered a heart scan or any additional health checks for rheumatic heart disease.

“That means our current services may not align with the values and needs of Maaori whaanau and Pacific aiga, and of significant concern for our large high-needs population in Counties Manukau is the notable lack of a culturally reflective workforce.”

To address this, Dr Webb’s team aims to improve access to scans by training Maaori and Pacific nurses to perform focused echocardiograms for rheumatic heart disease and by implementing a trial programme for siblings of ARF patients.

Maaori and Pacific health researchers led by co-investigators Dr Anneka Anderson, Dr Rachel Brown and Dr Florina Chan Mow will also facilitate interviews, hui and fono with whaannau to understand their experiences of the process and their preferences regarding a sibling echocardiography programme.

She anticipates the project overall will improve patient and whaanau engagement with frontline services as well as improve long-term outcomes for individuals by actively finding cases early.

“There is a good theoretical case for earlier detection of rheumatic heart disease.

“If a heart scan picks up rheumatic heart valve damage in the early (mild) stages, that person could have long-term treatment with penicillin and their health outcomes would typically be very good, with them leading a normal active life.”

CM Health’s Dr Adrian Trenholme was also awarded a Research Project Grant in addition to a Research Activation Grant, Summer Hawke and Jennifer Parr received Research Activation Grants, and Te Hao Apaapa-Timu and Bobbie-Jo Pene received Career Development Awards.


Pic: (L-R) Dr Florina Chan Mow, Dr Rachel Webb and Dr Pip Anderson


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