Jones, Benjamin

Turner, Angus W

Marangou, James

Yan, Jennifer

Burgess, Paul

Kaethner, Alex

Howard, Natasha

English, Mike

Nagraj, Shobhana

Francis, Joshua

2025-02-01

Australia has some communities with the highest rates of rheumatic heart disease (RHD) in the world. Echocardiographic detection of RHD through active case finding has been proposed for early detection. Lessons can be learnt from the implementation of a similar program - diabetic retinopathy screening. The aim of this paper is to identify transferable lessons from the implementation of diabetic retinopathy screening that could be applied to RHD echocardiographic detection.This paper presents a narrative review and expert recommendations.Transferable lessons from the implementation of diabetic retinopathy screening include training local staff regularly with formal certification; supplementary health promotion; program champions; general practitioner involvement; informing all staff at clinics; creating separate Medicare Benefits Schedule items for acquisition and interpretation; using echocardiography for detection and monitoring of RHD; establishing referral pathways and communication channels; local community involvement in implementation planning; and developing an adaptable program.Implementing programs successfully and sustainably in remote communities is known to be challenging. These transferable lessons from the implementation of diabetic retinopathy screening might assist in the planning of an RHD detection program.

MD, MHLM, Health Systems Collaborative, University of Oxford, Oxford, UK; Honorary Research Fellow, Menzies School of Health Research, Darwin, NT.

MBBS (Hons), MSc (Oxon), FRANZCO, Associate Professor, Centre for Ophthalmology @ Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, WA.

MBBS, FRACP, Honorary Research Fellow, Menzies School of Health Research, Darwin, NT.

MBBS, FRACP, Senior Research Fellow, Menzies School of Health Research, Darwin, NT; Paediatrician and Paediatric Infectious Diseases Physician, Department of Paediatrics, Royal Darwin Hospital, Darwin, NT.

MBBS, BMedSci, MPH, GradDipRuralGP, FRACGP-RG, FARGP, PhD, FAFPHM, GAICD, Director of Health Statistics and Informatics, Northern Territory Health, Darwin, NT.

BHlthSc, Cardiac Sonographer, Menzies School of Health Research, Darwin, NT.

BHlthSc (Hons), PhD, Associate Professor, South Australian Health and Medical Research Institute, Adelaide, SA.

MBBChir, MRCP, MD, FMedSci, Professor, Health Systems Collaborative, University of Oxford, Oxford, UK.

BSc (Hons), MBBS, MRCS, MRCGP, MPhil, DPhil, SFHEA, Associate Professor, Department of Public Health @ Primary Care, University of Cambridge, Cambridge, UK; Honorary Visiting Clinical Researcher, Health Systems Collaborative, University of Oxford, Oxford, UK.

MBBS, FRACP, Associate Professor, Menzies School of Health Research, Darwin, NT; Paediatrician and Paediatric Infectious Diseases Physician, Department of Paediatrics, Royal Darwin Hospital, Darwin, NT.

Aust J Gen Pract . 2025 Jan-Feb;54(1-2):75-79. doi: 10.31128/AJGP-05-24-7294.

2208-7958

https://pubmed.ncbi.nlm.nih.gov/39909005/?otool=iaurydwlib

https://hdl.handle.net/10137/14010

Humans

Rheumatic Heart Disease

Australia

Diabetic Retinopathy

Mass Screening

Echocardiography

Recommendations for implementing rheumatic heart disease echocardiographic detection in remote Australia: A narrative review and lesson-drawing from diabetic retinopathy screening.

Journal Article

Publication