Diverse diagnostic and management approaches for acute rheumatic fever in Australia and New Zealand: findings of a prospective clinical study.
BMJ open·
- DOI
- 10.1136/bmjopen-2025-099827
- PMID
- 40675648
- PMCID
- PMC12273072
- OpenAlex
- W4412490479
- Study type
- Cohort study
- Publisher
- Publisher unavailable
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Documented discrepancies in clinical workflows and patient outcomes underscore the necessity for harmonized regional guidelines tailored to specific epidemiological contexts.
Structured evidence summary
Research question
To characterize diagnostic procedures and treatment strategies for acute rheumatic fever across distinct healthcare environments in Australia and New Zealand.
Study design
A prospective cohort investigation utilizing multisite data collection across three hospitals in northern Australia and New Zealand from 2018 to 2021.
Population and setting
The cohort comprised 141 individuals recording 143 acute rheumatic fever episodes, primarily consisting of Indigenous youth between five and twenty-three years of age.
Main findings
Disease manifestations demonstrated considerable heterogeneity, with cardiac involvement occurring in over half of the recorded episodes. Cross-national comparisons revealed marked disparities in historical disease patterns, laboratory utilization, and positive streptococcal culture rates. Valvular pathology emerged as a primary factor extending hospital admission duration, while erythrocyte sedimentation rate testing offered additional diagnostic value beyond standard inflammatory markers.
Public-health relevance
Documented discrepancies in clinical workflows and patient outcomes underscore the necessity for harmonized regional guidelines tailored to specific epidemiological contexts.
Important limitations
The analytical framework depends on descriptive summaries and regression techniques applied to a geographically confined sample with a highly specific demographic composition, which may restrict broader generalization.
GIDS interpretation
This publication catalogs regional clinical practices and laboratory utilization patterns for acute rheumatic fever, serving as a foundational reference for tracking diagnostic trends and care standardization efforts.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 9 auditable classifier relationships to diseases, places, topics, and study design.