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Primary care management of group A streptococcal pharyngitis in Northland.
[acute rheumatic fever]
Reducing
the
rate
of
acute
rheumatic
fever
nationally
by
two
-thirds
by
2017
is
a
New
Zealand
Ministry
of
Health
priority
.
Northland
District
Health
Board
(
DHB
)
has
high
rates
of
rheumatic
fever
,
disproportionately
impacting
on
Maori
children
and
young
people
.
School
-based
programmes
and
general
practice
both
contribute
to
rheumatic
fever
prevention
in
detecting
and
appropriately
treating
group
A
streptococcal
(
GAS
)
pharyngitis
.
The
aim
of
this
study
was
to
assess
adherence
by
general
practitioners
and
school
-based
sore
throat
programmes
to
national
guidelines
for
the
management
of
GAS
pharyngitis
in
Northland
.
Laboratory
and
pharmaceutical
data
were
obtained
for
children
and
young
people
aged
3
-
20
years
who
had
GAS
positive
throat
swabs
in
Northland
laboratory
services
between
1
April
and
31
July
2012
.
Data
were
analysed
separately
for
general
practice
and
the
school
programmes
for
rheumatic
fever
prevention
.
One
in
five
of
those
children
presenting
to
general
practice
with
a
positive
throat
swab
and
complete
prescription
data
did
not
receive
treatment
according
to
national
guidelines
,
while
appropriate
treatment
was
offered
to
more
than
98
%
of
children
accessing
school
-based
programmes
.
A
significant
proportion
of
those
seen
in
general
practice
received
antibiotics
not
recommended
by
guidelines
,
an
inadequate
length
of
treatment
or
no
prescription
.
There
were
no
significant
differences
in
the
management
of
Maori
and
non-
Maori
children
.
There
is
room
for
improvement
in
general
practice
management
of
GAS
pharyngitis
in
Northland
.
School
-based
management
of
sore
throat
provides
high
-quality
management
for
children
at
high
risk
of
rheumatic
fever
.
Diseases
Validation
Diseases presenting
"high risk"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
aniridia
canavan disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
harlequin ichthyosis
heparin-induced thrombocytopenia
hirschsprung disease
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
krabbe disease
legionellosis
liposarcoma
locked-in syndrome
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
phenylketonuria
primary hyperoxaluria type 1
severe combined immunodeficiency
sneddon syndrome
waldenström macroglobulinemia
werner syndrome
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