Date of Award

2023

Degree Name

Master of Philosophy (School of Arts and Sciences)

Schools and Centres

Arts & Sciences

First Supervisor

Professor Martin Drum

Second Supervisor

Professor Gerard Hoyne

Abstract

This thesis examines the challenges associated with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) and the persistent prevalence of these diseases in the Australian context. In particular, the study focuses on the high resurgence of these preventable conditions within the Australian Aboriginal and Torres Strait Islander and Torres Strait Island population. The study begins with an initial analysis on the initial infection of the Group A streptococcus (GAS: Streptococcus pyogenes). We then examine current knowledge of the mechanisms which permit the transmission and development GAS infections, leading to ARF and RHD. This chapter explores current challenges associated with the prevention and management of GAS infections, ARF and RHD. There is compelling evidence to suggest a major role of socio-determinants of health in the predispositions of certain groups of people to increase their risk of contracting GAS infections and going on to develop ARF and RHD. Our health policy analysis, through the lens of the Walt and Gilson model, provides a relevant, extensive and systemic approach to the identification of core issues affecting the Australian policy response towards ARF and RHD and provides recommendations for future efforts. The findings of this research suggest there are significant gaps in the development and implementation of the RFS and a more tailored approach is required to address the unique social, behavioural and environmental factors that continue to contribute to the negative health outcome of Aboriginal and Torres Strait Islander people. We conclude that a more effective policy response can be successfully integrated for the complete prevention and eradication of ARF and RHD in the Australian context and reduce the significant burden of disease for Aboriginal and Torres Strait Islander people and their family.

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