ARF and RHD aboriginal : Nursing Case Study Analysis/ Nursing Assignment/Essay/Case Study Help Tutor

REFLECT: Epidemiology of Rheumatic Heart Disease

Acute rheumatic fever and rheumatic heart disease are one of the most preventable Health

problems affecting majority of Aboriginal and Torres Strait Islander population in Australia.

Acute rheumatic fever is an autoimmune response to occurrence of upper respiratory

infection caused by group A streptococcal infection (Katzenellenbogen et al., 2020). In

Australia, in the year 2015-2019, total 5385 individuals were living with rheumatic heart

disease. Out of this, more than 3 in 10 people (1558) were under the age of 25 years old and 2

in 3 (3561) were females. majority of cases were from Northern Territory (2308). More

importantly, 4 in 5 people were indigenous in origin (4337) accounting for 81% of the total

cases (Australian Institute of Health and Welfare, 2021).

The median age for diagnosis of RHD in indigenous population was 22 years which

was way younger than non-indigenous population (50years). Additionally, more than 1325

new cases of RHD were reported in indigenous Australians in the year 2015-2019. Similarly,

fresh RHD diagnosis was more common in female indigenous population in comparison to

males i.e., 76 in females and 44 in males per 1,00,000 population (Australian Institute of

Health and Welfare, 2021).

Half of the reported clients with RHD diagnosis were under the age of 25years (723

cases). Majority of cases of RHD in indigenous population was from northern territory i.e.,

557 or 150 per 1,00,000 population (Australian Institute of Health and Welfare, 2021).

Considering mortality, in the year 2015-2019, total 399 deaths were reported with RHD, out

of which nearly 72% (289) were indigenous clients. the median age for death was 52 years in

indigenous population in males and 53 years for females. this is much low in comparison to

non-indigenous population where median age was 72years for males and 71 years for females

(Australian Institute of Health and Welfare, 2021).

The most important risk factors responsible for causing RHD in Mae’s case is history

of acute rheumatic fever when she was 6 years old after she developed group A streptococcal

throat infection. She also has history of throat and infection; chronic tonsilitis as a child and

adolescent (He et al., 2016, pp. 223). This can be explained by the fact that recurrent throat

infections which remain untreated or undertreated by blood spread reach heart, skin, joints,

brain and other organs to cause inflammation. With history of group A streptococcal

infection, Mae developed acute rheumatic fever which led to development of rheumatic heart

disease (Katzenellenbogen et al., 2017). Another important non-modifiable risk factor in this

case is that Mae belongs to indigenous origin which inherently have high risk of having RHD

(Wyber et al., 2020, pp. S10).