First–time episodes of rheumatic fever in Northland drop
29 September 2016
First–time episodes of rheumatic fever in Northland drop dramatically
Photo – Five year old Abe Botur shows off his completed antibiotics sticker chart.
Northland DHB is seeing positive results from a campaign to get children treated for Strep Throat A. First-time episodes of rheumatic fever have dropped from 15 in 2014 to five cases in 2015 and in 2016 just one case was reported.
It is likely that the focus on early identification and management of strep throat, much greater access for children at risk to free treatment via schools and pharmacies, and an extensive national and regional communications strategy have contributed to the recent decline.
The school-based throat swabbing programme in all schools decile 1-4 in Northland is delivered by non-government organisation providers along with Public Health nurses providing opportunistic throat swabbing in schools, rapid response clinics in three pharmacies, free GP services for under 13 year olds, and the Sore Throats Matter publicity campaign.
Northland’s Medical Officer of Health Dr Clair Mills says the throat-swabbing projects were set up to combat rheumatic fever in the North.
“As well as a reduction in the number of new cases of rheumatic fever, we see that families are more aware of the importance of treating sore throats and preventing rheumatic fever. However, there is no room for complacency because many of the risk factors that contribute to rheumatic fever, such as poor housing, still exist in Northland.”
The School Based throat swabbing programme is delivered by Māori Health Providers Hokianga Health, iMoko, Te Hau Ora O Ngapuhi, Te Rūnanga O Whaingaroa, Ki A Ora Ngātiwai and Ngāti Hine Health Trust.
Schools are chosen on the basis of historically high numbers of rheumatic fever. Community health workers visit the schools three times a week to swab any children with sore throats, and if a child tests positive for Strep A, a ten day course of antibiotics is provided free of charge.
“One of the key advantages of the school programmes is that they are free, universal and don’t depend on factors over which children themselves have no control – such as cost, and the logistics of getting an appointment and transport to a doctor or nurse,” Dr Mills said.
The comprehensive campaign is all about preventing rheumatic fever in Northland by curing the Streptococcus bacteria which can cause the inflammatory disease. The end goal is total eradication of rheumatic fever in Northland.
“Preventing rheumatic fever not only saves cost to families, society and the health sector – it represents a better future for up to twenty young people and their families every year.”
Abe Botur, 5, benefited when Northland DHB public health nurses picked up his Strep Throat infection in early September. Abe had had a sore throat for two weeks before nurses swabbed his throat at Whangarei Primary School. His parents were then informed and Amoxicillin was given to him at school, along with a sticker chart so Abe could keep track of his ten doses of antibiotic.
These sticker charts have been particularly effective in increasing rates of adherence, meaning family members ensure the entire course of antibiotics is taken over the prescribed number of days.
Abe said his Northland DHB sticker chart, which allowed him to ‘wipe out’ cartoon germs over ten days, was “Cool” and he enjoyed filling it up.
Abe said filling up the sticker chart also meant he was allowed a reward from his “treasure chart box” (sic).
Abe described the Amoxicillin antibiotic as very palatable. “I fink it was banana…banana milk,” Abe said.
Billboards featuring children from local schools have also proven effective in delivering the Sore Throats Matter message which urges parents to have their child receive a throat swab via a nurse or doctor. Those billboards were placed throughout rural Northland communities such as Kaikohe, Kaeo, Rawene and Moerewa.
Northland DHB has also ensured advertisements in print and on radio let Northland whānau know tips to keep their homes warm and dry, as cold, damp and mouldy homes have been linked to rheumatic fever.
Top tips to help keep your home warmer, drier and healthier
· Open your curtains during the day and close them at night. Your windows let heat in during the day. Closing curtains before sunset keeps the heat in, and the cold out, at night.
· Stop cold air getting into your home by stopping draughts around doors, windows and fireplaces. Stopping cold air coming in makes it easier to heat your home and helps reduce the cost of heating.
· Open your windows (ventilate) for at least a few minutes each day. Fresh air helps to keep your home dry, makes it easier to heat your home, and helps reduce the cost of heating.
· Wipe off any water that has collected (condensation) on walls and on the inside of windows.
· Doing this helps to keep your home dry, which makes your home easier to heat and reduces the cost of heating.
Dry you’re washing outside or in the garage or carport. It keeps the dampness from your washing (which can build up condensation) outside of your home.