Rheumatic fever rates as indicator of NZ’s child health
Rheumatic fever rates a shameful indicator of NZ’s child health
The Heart Foundation is calling for rheumatic fever, a third world disease affecting New Zealand’s most vulnerable communities, to be eradicated by 2020.
This follows the release of an editorial in the New Zealand Medical Journal by Heart Foundation Medical Director, Professor Norman Sharpe and Public Health Medicine Registrar, Michael Hale, due to be released tomorrow (11 February).
"Rheumatic fever is a disease of poverty and overcrowding. The fact that rates of rheumatic fever in New Zealand children have not decreased over the past 30 years, in line with almost all other developed countries, is a national embarrassment," says Professor Sharpe.
“Rheumatic fever urgently needs increased leadership and priority for eradication and should be regarded as a key indicator of child health and how we as a community value our children,” he says.
Rheumatic fever is a preventable childhood infection, caused by the body's immune response to a streptococcal infection of the throat. This response affects the joints and the heart valves and can lead to long-term heart damage requiring surgery. It occurs alongside other childhood diseases including chest and skin infections, which are also related to social deprivation and urgently need attention.
“We are calling for a comprehensive approach to eradication, where the hard work of numerous individuals and organisations needs to be joined with strong national leadership to make eradication a priority,” says Professor Sharpe.
"In the United States, a cardiologist may never see a single case, and yet here there are nearly always kids in Starship Hospital with the condition," he says.
Rheumatic fever and resultant rheumatic heart disease reflect gross and intolerable health inequalities being 23 and 50 times more likely in Maori and Pacific people respectively than in European/other and 30 times more likely in the most socio-economically deprived groups.
The disease is eminently preventable and casts a long shadow, with a large consequent adult disease burden and a high cost to individuals, families, the community and the health system.
This year has seen the establishment of a national steering group to work alongside the Ministry of Health and with providers to raise the profile of rheumatic fever in the sector and in the community, coordinate linkages, and work to promote effective evidence-based interventions for accelerated improvement.
Rheumatic fever has been addressed and is mostly unheard of in other developed countries.
“Success in eradication in Cuba and Costa Rica has shown that even in poorer countries, dramatic reductions are possible with a comprehensive approach. In New Zealand, the town of Whangaroa eradicated a previous epidemic through a community led, school-based clinic,” says Professor Sharpe.