The diseases caused by GAS are a major cause of death and disability globally, especially in developing countries, leading to an estimated 500,000 premature deaths per year. GAS causes a wide array of clinical disease, from sore throat (commonly known as strep throat) and impetigo, to more serious post-infection complications including rheumatic heart disease (RHD).
In susceptible people, particularly those living in crowded conditions, untreated GAS can quickly turn into severe pain in the joints, high fever and shortness of breath - the early signs of RHD. For many, the warning signs come too late. There is a particularly high burden of undiagnosed RHD in the Pacific island of Fiji, where A/Professor Steer has been working alongside local healthcare workers to aid early diagnosis of the disease. In fact, the Pacific region has the highest occurrence of RHD in the world and the mean age of death for RHD patients in Fiji is in the early 30’s.
As part of their preliminary studies, A/Professor Steer’s team found that RHD was more common in females and in children who attended school in a rural location. In a world first, the team provided field training for local health staff to perform an echocardiogram to screen children from 10 primary schools in Fiji for early symptoms of the disease.
The echocardiogram was subsequently read by a paediatric cardiologist. Regular penicillin shots were administered to stop the progress of the disease for those children confirmed to have RHD. With the support of the Fiji Ministry of Health, more than 10,000 Fijian children have now been screened and treated. In 2014, the Group A Streptococcal Research Group, along with key collaborative partners, were awarded $3 million from New Zealand Government’s International Aid program to support ongoing work.
The results of A/Professor Steer’s work highlight the importance of highly accurate echocardiography in a region where early detection is so vital. The Fiji program acted as the pilot program, and the team now looks to a much broader piece of work across the Pacific where diseases caused by GAS are epidemic.