On-country sonography program saving lives

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Smiling woman with suitcase sitting in front of tree
Cardiac sonographer Sheena Foskett performs echocardiograms in community across the Torres and Cape HHS region.

More than 900 people in the Torres Strait, Cape York and Northern Peninsula Area were able to undergo heart scans in their home communities last year due to a pioneering program helping tackle Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD).

During 2023, the Torres and Cape Hospital and Health Service delivered echocardiograms to children and adults in 22 communities across the region.

The program is expected to expand to 28 communities this year.

First Nations peoples are one of the major at-risk groups for RHD and ARF, meaning early access for an echocardiogram is vital for residents in the Torres and Cape area.

The Torres and Cape HHS recorded 28 cases of ARF and 28 cases of RHD during 2023, compared with 25 ARF and 64 RHD in 2022.

To date in 2024 there have been four cases of ARF and one case of RHD.

The figures come as Queensland Health marks Cardiac Research Month during February - raising awareness for heart health and highlighting the need for research funding.

Torres and Cape HHS Acting Director of Nursing Clinical Coordination Frank Grainer said the Combined Cardiac Service – a joint project between our health service and the Cairns and Hinterland Hospital and Health Services – was launched in 2019 after being identified as a high- need service.

“Sadly this is due to the overwhelming burden of chronic disease and RHD for Aboriginal and Torres Strait Islander people,” he said.

“The on-country sonography service has really evolved and expanded and to be able to deliver this service in communities and closer to home for our residents, it is saving people’s lives.”

Torres and Cape HHS cardiac sonographer Sheena Foskett said more than a third of the echocardiograms she performed during 2023 were on people with RHD.

“Rheumatic heart disease is a disease of poverty and disadvantage. It was essentially eliminated in non-Indigenous Australian population decades ago and shouldn’t exist in a prosperous country like Australia,” she said.

“RHD is most commonly diagnosed in children and young adults and is a diagnosis they will carry with them for the rest of their life.

“I believe everyone should be entitled to the same access to services no matter where they live which is why I am so passionate about delivering this on-country program.”

Torres and Cape HHS Executive Director of Medical Services Dr Marlow Coates said once people with ARF or RHD were identified they could receive treatment to prevent it from causing long-term cardiac damage such as heart failure and strokes.

“Once diagnosed with ARF or RHD, patients require regular scans to ensure appropriate ongoing management and it’s important that they turn up to their scheduled appointments for these scans,” he said.

“That’s why having an on-country service to deliver these scans is a huge benefit and highlights our dedication to bringing services closer to home.

“Acute rheumatic fever and rheumatic heart disease are often not recognised by the community as a big problem, but as a health service we are focused on both preventative and treatment measures.’’

Acute rheumatic fever is a disease caused by the Streptococcus A bacteria group (strep) which causes throat and skin infections and can lead to inflammation in the joints, brain, and heart.

The infection can be spread from person to person by large respiratory droplets, for example via sneezing, or direct contact with people infected by the bacteria, and can progress into rheumatic heart disease.

Dr Coates said parents and carers of children should be aware of the signs of ARF, including sore throat, sore joints, fever, or skin sores, and seek treatment.

Read more about Rheumatic heart disease | Queensland Health.