Senior Technical Adviser
MBChB MPH FRACGP
Dr Rosemary Wyber completed her medical degree in New Zealand, her Masters of Public Health at the Harvard School of Public Health and her General Practice registrar training in the Northern Territory. Her research interests are rheumatic heart disease and diseases of disparity in vulnerable populations. Rosemary is a Senior Adjunct Research Fellow at the University of Western Australia and the Head of Strategy for END RHD.
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Projects
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Publications
March 2021
Modes of transmission and attack rates of group A Streptococcal infection: a protocol for a systematic review and meta-analysis
Group A Streptococcus (Strep A) is an important cause of mortality and morbidity globally. This bacterium is responsible for a range of different infections and post-infectious sequelae. Summarising the current knowledge of Strep A transmission to humans will address gaps in the evidence and inform prevention and control strategies. The objective of this study is to evaluate the modes of transmission and attack rates of group A streptococcal infection in human populations.
Published research Infectious Diseases Subsite: Wesfarmers Centre of Vaccines and Infectious Diseases Invasive Streptococcus A DiseaseApril 2021Structured review of primary interventions to reduce group A streptococcal infections, acute rheumatic fever and rheumatic heart disease
Rheumatic heart disease (RHD) is a large, preventable, global public health burden. In New Zealand (NZ), acute rheumatic fever (ARF) and RHD rates are highest for Māori and Pacific children. This structured review explores the evidence for primary prevention interventions to diagnose and effectively treat group A Streptococcus (GAS) pharyngitis and skin infections to reduce rates of ARF and RHD.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseMay 2021Formative evaluation of a community-based approach to reduce the incidence of Strep A infections and acute rheumatic fever
We explore the acceptability of a novel, outreached-based approach to improve primary and primordial prevention of Strep A skin sores, sore throats and acute rheumatic fever in remote Aboriginal communities. A comprehensive prevention program delivered by trained Aboriginal Community Workers was evaluated using approximately fortnightly household surveys about health and housing and clinical records.
Published research Rheumatic Heart Disease Skin Infections Aboriginal Health Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Subsite: END RHD Invasive Streptococcus A DiseaseMay 2021Primary prevention of acute rheumatic fever
Acute rheumatic fever (ARF) is an abnormal immune reaction following Streptococcus pyogenes (Strep A) infection of the throat, and likely the skin. Primary prevention is the prompt and appropriate antibiotic treatment of Strep A infection, and it can reduce the risk of developing ARF and subsequent rheumatic heart disease.
Published research Rheumatic Heart Disease Skin Infections Infectious Diseases Subsite: Wesfarmers Centre of Vaccines and Infectious Diseases Subsite: END RHD Invasive Streptococcus A Disease Skin HealthAugust 2021Protocol for the systematic review of the epidemiology of superficial Streptococcal A infections (skin and throat) in Australia
We have produced a protocol for the comprehensive systematic review of the current literature around superficial group A Streptococcal infections in Australia.
Published research Group A Streptococcal & Rheumatic Heart Disease Subsite: END RHD Invasive Streptococcus A DiseaseAugust 2021Improving the well-being for young people living with rheumatic heart disease: A peer support pilot program through Danila Dilba Health Service
Aboriginal and Torres Strait Islander peoples in Australia have an inequitable burden of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), concentrated among young people and necessitating ongoing medical care during adolescence. There is an unmet need for improved well-being and support for these young people to complement current biomedical management.
Published research Rheumatic Heart Disease Aboriginal Health Subsite: END RHDOctober 2021A community-based program to reduce acute rheumatic fever and rheumatic heart disease in northern Australia
In Australia’s north, Aboriginal peoples live with world-high rates of rheumatic heart disease (RHD) and its precursor, acute rheumatic fever (ARF); driven by social and environmental determinants of health. We undertook a program of work to strengthen RHD primordial and primary prevention using a model addressing six domains: housing and environmental support, community awareness and empowerment, health literacy, health and education service integration, health navigation and health provider education.
Published research Rheumatic Heart Disease Aboriginal Health Subsite: END RHDDecember 2020Quality of benzathine penicillin G: A multinational cross-sectional study
Benzathine penicillin G (BPG) is used as first-line treatment for most forms of syphilis and as secondary prophylaxis against rheumatic heart disease (RHD). Perceptions that poor quality of BPG is linked to reported adverse effects and therapeutic failure may impact syphilis and RHD control programs. Clinical networks and web-based advertising were used to obtain vials of BPG from a wide range of countries.
Published research Immunisation Rheumatic Heart Disease Infectious Diseases Allergy & Infectious Diseases Infectious Diseases EpidemiologyNovember 2020Ending rheumatic heart disease in Australia: the evidence for a new approach
The RHD Endgame Strategy: the blueprint to eliminate rheumatic heart disease in Australia by 2031 (the Endgame Strategy) is the blueprint to eliminate rheumatic heart disease (RHD) in Australia by 2031. Aboriginal and Torres Strait Islander people live with one of the highest per capita burdens of RHD in the world.
Published research Rheumatic Heart Disease Aboriginal Health Subsite: END RHDOctober 2020Subcutaneous administration of benzathine benzylpenicillin G has favourable pharmacokinetic characteristics for the prevention of rheumatic heart disease compared with intramuscular injection
Benzathine penicillin G has been used as monthly deep intramuscular (IM) injections since the 1950s for secondary prevention of acute rheumatic fever and rheumatic heart disease (RHD). Injection frequency and pain are major programmatic barriers for adherence, prompting calls for development of better long-acting penicillin preparations to prevent RHD.
Published research Immunisation Rheumatic Heart Disease Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Infectious Diseases EpidemiologyFebruary 2020Voices behind the statistics: A systematic literature review of the lived experience of rheumatic heart disease
This systematic review presents a critical, interpretive analysis of publications that include lived experiences of rheumatic heart disease
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJanuary 2019Time to tackle rheumatic heart disease: Data needed to drive global policy dialogues
This report provides an update on the contemporary global and regional policy landscapes relevant to rheumatic heart disease
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJune 2019Severe adverse events following benzathine penicillin G injection for rheumatic heart disease prophylaxis: cardiac compromise more likely than anaphylaxis
These results indicate that anaphylaxis is not a major cause of adverse reactions to benzathine penicillin G
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJune 2019Call for a national sore throat guideline
Australia needs a single national pharyngitis guideline to assist in providing rational, consistent and timely antibiotic treatment to patients at high risk of ARF
Published research Group A Streptococcal & Rheumatic Heart DiseaseSeptember 2019Public health and economic perspectives on acute rheumatic fever and rheumatic heart disease
Efforts to eliminate ARF and RHD in Australia over the past decade have so far been unsuccessful, but this can change
Published research Rheumatic Heart Disease Infectious Diseases Group A Streptococcal & Rheumatic Heart DiseaseNovember 2019The end rheumatic heart disease in Australia study of epidemiology (ERASE) project: Data sources, case ascertainment and cohort profile
The ERASE Project has created an unprecedented linked administrative database on acute rheumatic fever and rheumatic heart disease in Australia
Published research Rheumatic Heart Disease Infectious Diseases Group A Streptococcal & Rheumatic Heart DiseaseNovember 2019Availability and administration of benzathine penicillin G for the prevention of rheumatic fever in Africa: Report of the Working Group on Penicillin
Benzathine penicillin G availability should be addressed and African health workers’ knowledge and practices need to be augmented
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJune 2018Lessons learned in the development of sustained release penicillin drug delivery systems for the prophylactic treatment of rheumatic heart disease (RHD)
The current prophylactic treatment to prevent rheumatic heart disease requires four-weekly intramuscular injection of a suspension of the poorly soluble benzathine salt form of penicillin G (BPG) often for more than 10 years. In seeking to reduce the frequency of administration to improve adherence, biodegradable polymer matrices have been investigated.
Published research Group A Streptococcal & Rheumatic Heart DiseaseJanuary 2017Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem
We aimed to review RHD burden in Western Pacific Region outside Oceania to identify countries with high RHD burden
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseMarch 2017A Comprehensive Needs Assessment Tool for Planning Rheumatic Heart Disease Control Programs in Limited Resource Settings
RHD is an important cause of disability and death in low- and middle-income countries.
Published research Group A Streptococcal & Rheumatic Heart DiseaseOctober 2017The rationale for action to end new cases of rheumatic heart disease in Australia
The choice of RHD is telling: the disease is a marker of inequality, a novel lens for considering health systems and a feasible target for disease control.
Published research Aboriginal Health & Wellbeing Group A Streptococcal & Rheumatic Heart DiseaseNovember 2017Rheumatic heart disease: infectious disease origin, chronic care approach.
Rheumatic heart disease (RHD) is a chronic cardiac condition with an infectious aetiology, causing high disease burden in low-income settings.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseOctober 2016Preliminary consultation on preferred product characteristics of benzathine penicillin G for secondary prophylaxis of rheumatic fever
A sample target product profile for reformulated benzathine penicillin G is presented
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseMarch 2016The WHF Roadmap for Reducing CV Morbidity and Mortality Through Prevention and Control of Rheumatic Heart Disease
As a general guide, the Roadmap is meant to serve as the foundation for the development of tailored plans of action to improve RHD control in specific contexts.
Published research Human Immunology Group A Streptococcal & Rheumatic Heart DiseaseFebruary 2016Myositis complicating benzathine penicillin-G injection in a case of rheumatic heart disease
A 7-year old boy developed myositis secondary to intramuscular injection of benzathine penicillin-G in the context of secondary prophylaxis for RF
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseAugust 2015Supply of benzathine penicillin G: the 20-year experience in Australia
Reliable supplies of BPG are essential for delivering the recommended schedule of secondary prophylaxis for people living with RHD.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJuly 2015Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort
To describe the pattern of RHD occurrence in a sample of presenting cases from an occupational cohort in Papua Province, Indonesia.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJune 2015Treating trade: the case for clinical engagement with regional trade agreements
The global burden of non-communicable diseases (NCDs) continues to grow. Although developing settings face fastest growth in incidence, no country is exempt.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseJanuary 2015Big data in global health: Improving health in low- and middle-income countries
Over the last decade, a massive increase in data collection and analysis has occurred in many fields.
Published research Group A Streptococcal & Rheumatic Heart DiseaseMay 2015Evolution, Evidence and Effect of Secondary Prophylaxis Against Rheumatic Fever
The association between group A streptococcal infection and rheumatic fever (RF) was established in the early 20th century.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseMarch 2015The 5 × 5 path toward rheumatic heart disease control: Outcomes from the third rheumatic heart disease forum
This editorial viewpoint regarding the outcomes from the third global Rheumatic Heart Disease Forum intends to carry forward dialogue & engage new...
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseMarch 2015Rheumatic heart disease: Tools for implementing programmes
This article discusses the World Health Organization program for monitoring & managing rheumatic heart disease.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseSeptember 2014The case for global investment in rheumatic heart-disease control
The review built a case for extending simple and cost–effective measures to all countries. Had these recommendations been put into action, significant...
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseSeptember 2013Prevention of rheumatic fever and heart disease: Nepalese experience
Historically, many young people suffered severe valvular disease and died awaiting heart valve replacement.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseSeptember 2013A conceptual framework for comprehensive rheumatic heart disease control programs
The World Health Organization, World Heart Federation, and other organizations recommend comprehensive control programs for rheumatic fever (RF) and...
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseSeptember 2013Benzathine penicillin G for the management of RHD: Concerns about quality and access, and opportunities for intervention and improvement
Benzathine penicillin G is an important antibiotic for the treatment and prevention of group A streptococcal infections associated with rheumatic fever and...
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseSeptember 2013The second rheumatic heart disease forum report
Building on the foundation of the first RHD forum, over 150 interested participants met to discuss critical issues on the RHD landscape.
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart DiseaseMay 2013Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease
In the 21st century, rheumatic fever (RF) and rheumatic heart disease (RHD) are neglected diseases of marginalized communities.
Published research Immunisation Rheumatic Heart Disease Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease