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Northland community eliminates a heart disease

Northland community eliminates a heart disease

Public Health Conference 2004
Christchurch, June 30-July 1

Wednesday 30 June 2004

Regular visits to schools and swabbing children suffering from sore throats have eliminated new rheumatic fever cases in a previously hard-hit Northland community.

Northland medical officer of health Jonathan Jarman and Kaeo-based health worker Helen Herbert from Te Runanga o Whangaroa told the Public Health Conference that in recent years Maori children in Whangaroa aged 5-14 had a 'third-world' rate of rheumatic fever - more than ten times the rate than Maori children generally and twenty times the rate for non-Maori New Zealand children.

Rheumatic fever begins with a throat infection from a Group A Streptococcus pyogenes bacterium. If not treated, it can develop into acute rheumatic fever and then into chronic rheumatic heart disease which affects the person for the rest of their life.

It spreads from an infected person who coughs bacteria-hearing droplets to anyone within a metre of them. Risk factors include over-crowding of homes and poor access to medical care.

But a community-wide initiative beginning in August 2000 had resulted in the Whangaroa Rheumatic Fever project starting up a year later. Incentive plans for the secondary school and a marae-based approach to the local kura kaupapa Maori meant all schools in the area came aboard the project.

In February 2002, nurses started visiting six local schools three times a week and taking throat swabs from any child with a sore throat.

When the results returned from the lab they rang the family and told them the medicine was waiting to be picked up from the pharmacy.

The results were almost instant. Two weeks after the school visiting began, the last recorded case of childhood rheumatic fever in Whangaroa was notified to the Medical Officer of Health.

Engaging with the community from the beginning and working in partnership have been elements, project facilitator Helen Herbert said. Regular visiting and throat swabbing will continue for another two years, and a similar project for Kaitaia, which has one-third the previous rate of Whangaroa but still significant, is also being considered.


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