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Commentary on Remond et al.

机译：评论雷蒙德等。

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The Australian approach to dealing with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in Aboriginal and Torres Strait Islander people makes an interesting case study. Prior to the mid-1990s, there had been a few publications, largely based on hospital series or individual community experience that hinted at an enormous issue in remote Aboriginal communities of northern Australia. The year 1996 saw the publication of the first population-based data, from the Northern Territory, documenting the highest rates in the world of ARF and among the highest in the world of RHD, in the Aboriginal population.1 Simple epidemiological analyses confirmed two obvious factors contributing to these high rates: recurrences represented more than 40% of all ARF episodes (highlighting poor delivery of benzathine penicillin G secondary prophylaxis injections); and approximately 40% of patients with RHD presented with no prior history of ARF (highlighting poor mechanisms to diagnose ARF and enter people into prevention programs in the first place). Researchers at the Menzies School of Health Research worked with colleagues in the NT Department of Health to develop a strategy based on a World Health Organization recipe for RHD control - establishment of register-based RHD control programs. A proposal was made to the Commonwealth Government, some money was cobbled together from various pots, and the Top End RHD Control Program was born in 1997.
机译：澳大利亚针对土著居民和托雷斯海峡岛民的急性风湿热（ARF）和风湿性心脏病（RHD）的治疗方法引起了一个有趣的案例研究。在1990年代中期之前，已经有一些出版物，主要是基于医院系列报道或个人社区经验，这暗示了澳大利亚北部偏远的原住民社区的巨大问题。 1996年，北领地发布了第一批基于人口的数据，记录了原住民中ARF发生率最高，RHD发生率最高的情况。1简单的流行病学分析证实了两个明显的导致这些高发生率的因素：复发占所有ARF发作的40％以上（突出显示苄星青霉素G二级预防性注射的不良递送）;大约40％的RHD患者没有ARF的既往病史（首先要强调诊断ARF的不良机制并首先让人们参与预防计划）。孟席斯健康研究学院的研究人员与北领地卫生部的同事合作，根据世界卫生组织的RHD控制方法制定了一项策略-建立基于寄存器的RHD控制程序。向英联邦政府提出了一项建议，从各个花盆里凑了一些钱，“高端RHD控制计划”诞生于1997年。

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