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RHD findings set Josh on path to research success

Published:  16 November 2022

Research conducted by intern doctor Josh Liaw has shown the Townsville Hospital and Health Service (HHS) outreach programs are successful at improving health outcomes for children with Acute Rheumatic Fever (ARF).

Almost exclusively impacting First Nations families, ARF can progress into Rheumatic Heart Disease if not regularly prevented with monthly penicillin injections.

Dr Liaw said his research explored the number of children receiving their monthly injections of penicillin in Townsville compared to the national rates.

“Nationally, there is a struggle to get above a 50 per cent of ARF patients receiving their monthly penicillin injections adherence rate to prevent a more serious illness,” Dr Liaw said.

“Through this research, we determined that the Townsville region is above this 50 per cent threshold among children and young adults, however there is still a lot of room for improvement.

“There are several reasons children may miss their regular appointment for their penicillin including anxiety about the needles and the trauma of getting such regular treatment.

Dr Liaw said the success of increasing these adherence rates in Townsville could be attributed to the paediatric outreach program established by the Townsville HHS director of paediatrics Dr Andrew White and clinical nurse Louise Axford-Haines.

“The paediatric outreach clinic run by the paediatric outreach nurses have been pivotal in improving these adherence rates for First Nations children in the Townsville region,” he said.

“The biggest strength of the clinic has been the fact it has been designed for the specific audience it needs to treat.

“The clinic goes out into community, engages with these families and has incredibly supportive and well-trained staff who are delivering these services.

“It is resource intensive to offer this sort of clinic, but it’s a good example of providing culturally appropriate care and bridging the gap of health inequity for young Aboriginal Torres Strait Islander Children.”

Inspired by his first taste of research with three research papers under his belt and the support of James Cook University and the Townsville HHS, Dr Liaw is now doing a PhD and focusing on ears, nose and throat.

“I’m now part of a research group who are studying the bacteria which cause ear, nose and throat diseases,” Dr Liaw said.

“Our project is looking at novel microbiome transfers for people with chronic rhinosinusitis, which is an inflammatory disease impacting the lining of the sinuses and create extra mucus.


“It’s basically a reset in the nose for people suffering from this condition and is comparable to previous work done to transfer healthy gut bacteria from one person to another.

“I have no idea where I will end up once I finish my PhD, but I’m excited to see where this research takes me.”

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