MEDIA RELEASES

The epidemiology of acute rheumatic fever in Northland


Today the New Zealand Medical Journal is publishing The epidemiology of acute rheumatic fever in Northland, 2002–2011co-authored by Northland District Health Boards Paediatrician Dr Roger Tuck and Medical Officer of Health Dr Clair Mills with Audrey Robin and Diana Lennon.

“Rheumatic Fever rates are very high for school aged Māori in Northland, with an increasing (upward) trend in cases over 2002-2011”, explains Dr Tuck. “It is clear that the upstream issues of poverty, poor housing and overcrowding for our children still urgently need to be addressed”. 

More Information

Abstract

Aim: An audit of rheumatic fever surveillance in Northland was carried out for the period 2002-2011. The aim of the audit was to establish the accuracy and completeness of surveillance of Acute Rheumatic Fever in Northland, and to provide a robust baseline for future comparison given current rheumatic fever prevention efforts.

Methods: Cases of acute rheumatic fever (2002-2011) were identified and evaluated through auditing Northland hospital discharges, the Northland Rheumatic Fever secondary penicillin prophylaxis register and the national EpiSurv database. Cases were included in the audit if they met diagnostic criteria according to the 2008 Heart Foundation guidelines.

Results: A total of 114 acute rheumatic fever cases met the audit criteria, an annualised incidence of 7.7/100,000 in Northland. 95% of all cases were Māori with a large disparity between Māori (24.8/100,000) and non-Māori (0.6/100,000). Acute rheumatic fever cases were strongly associated with living in high deprivation areas. This audit noted both under- and over-notification of acute rheumatic fever.

Conclusion: Acute rheumatic fever rates in Northland Māori children aged 5-14

(78/100000) are similar to those seen in developing countries and nearly double the rates seen other New Zealand audits. The findings highlight the urgent need to address crowding, poverty and inequitable primary care access if rheumatic fever is to be eliminated. 


NZMA Epidemiology Rheumatic Fever Dr Mills.pdf



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