title: Prospective population-based study on the burden of disease from post-streptococcal glomerulonephritis of hospitalised children in New Zealand: epidemiology, clinical features and complications.
abstract: OBJECTIVE
  A nationwide 24-month study was conducted (2007-2009), via the New Zealand Paediatric Surveillance Unit to define epidemiology and clinical features of acute poststreptococcal glomerulonephritis (APSGN) in children hospitalised with the illness.
  
  
  METHODS
  Paediatricians (n = 215) were requested to report new hospitalised cases fulfilling a case definition of definite (haematuria with low C3 and high streptococcal titres or biopsy proven APSGN) or probable (haematuria with low C3 or high streptococcal titres).
  
  
  RESULTS
  A total of 176 cases were identified (definite: n = 138, probable: n = 38) with 63% residing in the Auckland metropolitan region. Sixty-seven percent were in the most deprived quintile. Annual incidence (0-14 years) was 9.7/100,000 (Pacific 45.5, Maori 15.7, European/other 2.6 and Asian 2.1/100,000). Annual incidence was highest in the South Auckland Metropolitan region (31/100,000), Central Auckland 14.9, West/North Auckland metropolitan region 5.9 and for the remainder of New Zealand 5.5/100,000. Age-specific incidence was highest in age 5-9 years (15.1/100,000). Reduced serum complement C3, gross haematuria, hypertension, impairment of renal function and heavy proteinuria were present in 93%, 87%, 72%, 67% and 44% of patients, respectively. Severe hypertension was closely associated with either symptoms of an acute encephalopathy or congestive heart failure.
  
  
  CONCLUSIONS
  New Zealand children carry a significant disease burden of hospitalised APSGN with socio-economically deprived; Pacific and Maori children are being over-represented. Significant short-term complications were observed in hospitalised children with APSGN. Persistently very low rates in European/other suggest a preventable disease.
authors.affiliation: Department of Paediatric Nephrology, Starship Children's Hospital, Auckland, New Zealand.
authors.forename: William
authors.initials: W
authors.lastname: Wong
authors.forename: Diana R
authors.initials: DR
authors.lastname: Lennon
authors.forename: Sonja
authors.initials: S
authors.lastname: Crone
authors.forename: Jocelyn M
authors.initials: JM
authors.lastname: Neutze
authors.forename: Peter W
authors.initials: PW
authors.lastname: Reed
mesh_terms: D000293:Adolescent; D001927:Brain Diseases / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D006333:Heart Failure / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000209:etiology; D015994:Incidence; D007223:Infant; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000150:complications*
keywords: New Zealand; epidemiology; post-streptococcal glomerulonephritis