title: Rheumatic fever in New Zealand.
abstract: Acute rheumatic fever and its sequel rheumatic heart disease remain major unsolved problems in New Zealand, causing significant morbidity and premature death. The disease burden affects predominantly indigenous Māori and Pacific Island children and young adults. In the past decade these ethnic disparities are even widening. Secondary prophylaxis using 28-day intramuscular penicillin has been the mainstay of disease control. In the greater Auckland region, audit shows community nurse-led penicillin delivery rates of 95% and recurrence rates of less than 5%. The true penicillin failure rate of 0.07 per 100 patient years supports 4 weekly penicillin rather than more frequent dose regimens. Landmark primary prevention research has been undertaken supporting sore throat primary prevention programmes in regions with very high rheumatic fever rates. Echocardiographic screening found 2.4% previously undiagnosed rheumatic heart disease in socially disadvantaged children. Combined with secondary prevention, echocardiography screening has the potential to reduce the prevalence of severe rheumatic heart disease.
authors: Department of Paediatrics, University of Auckland, Auckland, New Zealand.
authors: Rachel
authors: R
authors: Webb
authors: Nigel
authors: N
authors: Wilson
mesh_terms: D000328:Adult; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D010406:Penicillins / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods*; D012213:Rheumatic Fever / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D012214:Rheumatic Heart Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D055502:Secondary Prevention / Q000379:methods*
chemical_list: D010406:Penicillins