Rheumatic Fever Follow-Up Study – RhFFUS

RhFFUS follows in the footsteps of the earlier gECHO (getting Every Child’s Heart Okay) study, which found many children in northern and central Australia who had heart valve abnormalities of unclear and doubtful significance. In a setting where rates of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain amongst the highest in the world, it’s important to know whether these minor changes represent the earliest sign of RHD. RhFFUS will monitor the progress of children identified with minor heart valve abnormalities during the gECHO study to see whether they are at greater risk of developing RHD and/or contracting ARF.

The findings of RhFFUS will help inform the future response to RHD in this and other settings. In particular, it will allow primary health care providers (nurses, health workers and GPs) and specialists to understand the significance of subtle changes on echocardiography and to determine whether these represent the earliest changes of RHD or mere variations of normal heart anatomy. If children with an initial abnormal echocardiogram are shown to have an increased risk of ARF and/or progression to RHD, then a case may be made for identifying high risk children earlier through screening echocardiography and offering them benzathine penicillin antibiotic prophylaxis to prevent the development of RHD.

The Kimberley component of this project has been completed.


Remond, M. G.; Atkinson, D.; White, A.; Hodder, Y.; Brown, A. D.; Carapetis, J. R.; Maguire, G. P.  Rheumatic Fever Follow-Up Study (RhFFUS) protocol: a cohort study investigating the significance of minor echocardiographic abnormalities in Aboriginal Australian and Torres Strait Islander children. BMC Cardiovasc Disord. 2012;12:111


  • A/Prof Graeme Maguire
  • Prof David Atkinson
  • Dr Andrew White
  • Prof Alex Brown
  • Prof Johnathan Carapetis