The epidemiology of rheumatic fever in the Tairawhiti/Gisborne region of New Zealand: 1997-2009.
[acute rheumatic fever]
To establish Acute Rheumatic Fever (ARF) rates within the Tairawhiti District Health Board (1997-2009) to identify communities for primary prevention programmes.ARF cases (1997-2009) sought by audit of Gisborne Hospital admissions, penicillin prophylaxis lists and the EpiSurv notifiable disease database.ARF rates (n=44 cases) during 1997 to 2009 (7.6/100,000) with a continuing significant disparity between Maori (n=40, 15.2/100,000) and non-Maori, (n=3, 1.1/100,000). One case was Pacific. This disparity was marked in school-aged children (5-14 years: Maori 59/100,000 vs non-Maori 8/100,000). Over 80% of ARF cases demonstrated heart damage (18% moderate, 20% severe and 8% requiring heart surgery). ARF cases were strongly associated with living and schooling within high deprivation areas Forty ARF cases were enrolled in 13/21 Gisborne schools, 4/18 East Coast schools and 2/17 western rural schools. (No school for 8 cases). When assessed as a percentage of school rolls there were no discernable differences between primary, intermediate and secondary schools. Of the 44 cases, 35 (80%) resided in areas of NZDep06 score 8-10 (most deprived).Very high ARF rates were recorded in the 1960's; the continuing burden of ARF in Maori children indicate a strong requirement for primary prevention strategies. Progress has plateaued in the last 20 years.