Primary prevention of rheumatic fever in the 21st century: evaluation of a national programme

Abstract

Population-based primary prevention of ARF through sore throat management may be effective in well-resourced settings like NZ where high-risk populations are geographically concentrated. Where high-risk populations are dispersed, a school-based primary prevention approach appears ineffective and is expensive.

Post‐streptococcal glomerulonephritis: Some reduction in a disease of disparities

“…Over the years, from 2012 to 2015, during the RF programme, the admission rates for RF declined by 40% in the Auckland DHBs (https://www.health.govt.nz/our-work/diseases-and-conditions/rheumatic-fever/reducing-rheumatic-fever) It is possible that initiatives providing earlier and more accessible community treatment of streptococcal infection is impacting the rate of APSGN or that high levels of antibiotic use are reducing transmission pressure for GAS. Rates of RF have subsequently increased in 2016–2017, indicating the importance of the ongoing monitoring of GAS‐related disease, including APSGN . Further studies of APSGN are planned.…”

“…Rates of RF have subsequently increased in 2016-2017, indicating the importance of the ongoing monitoring of GASrelated disease, including APSGN. 24 Further studies of APSGN are planned.…”

School-based Streptococcal A Sore-throat Treatment Programs and Acute Rheumatic Fever Amongst Indigenous Māori: A Retrospective Cohort Study

“…The Ministry of Health (Health Ministry) initiated a National ARF Primary prevention program (RFPP) 2012–17 with 3 objectives: increasing ARF awareness, reducing household crowding, and improving priority communities’ access to streptococcal throat infection treatment. 17 “National” evaluation 2012–16 using discharges showed a 28% decline in all-age ARF incidence. Evaluation of school-based sore-throat service for 5–12 year-olds compared Education decile 1–3 ARF notifications estimating 23% (CI 6%–44%) effectiveness nationally and 46% (CI 16%–66%) in South Auckland .18…”

Beyond Sharing and Shifting: Raising the Bar for Global Rheumatic Heart Disease Control

“…Whereas the disease's natural history is a fixed constraint, team-based care has the potential to alleviate key human resource bottlenecks and improve coordination and accountability across the entire care cascade. Although there have been important advances in this regard in the recent past [13][14][15][16][17][18], the reality is that there remains a substantive know-do gap that needs to be filled; as noted by leadership at the U.S. National Heart, Lung, and Blood Institute, "the continuing challenge of RHD is not one of understanding how to prevent and treat it-but rather, a failure of widespread implementation of effective prevention and treatment" [19]. More implementation research is thus warranted [20,21].…”