ISSN ISSN 1178-6191

Maori Health Review

Making Education Easy Issue 86 - 2020

Maori Health Review

Distribution of Streptococcal pharyngitis and acute rheumatic fever, Auckland, New Zealand, 2010-2016

Authors: Oliver J, et al.

Summary: Ethnic disparities were found to be much higher among children with acute rheumatic fever than among children with GAS pharyngitis in a comparison of cases in Auckland during 2010–2016. Based on 1,257,058 throat swab samples, estimates of GAS pharyngitis occurred with similar incidence (≈19%) in children aged 5–14 years across ethnic groups. There were 792 hospitalisations for acute rheumatic fever during the same period with Māori and Pacific Island children at a higher risk than children of European/other ethnicity.

Comment: Some key points here in these two papers that suggest management of acute rheumatic fever in Aotearoa is an issue. Firstly, that recurrence rates are higher here than reported elsewhere. Second, that recurrence occurs in teenagers and young adults here in New Zealand, whereas it is more common in the 12 months after initial acute rheumatic fever (i.e. in childhood/young teens). And finally that it is more common in our biggest city (when rurality is a bigger risk factor internationally). We must get onto this! The second paper raises important questions about factors, other than GAS-positive swabs, that lead to acute rheumatic fever.

Reference: Emerg Infect Dis. 2020;26(6):1113-1121.


Rheumatic fever recurrences in New Zealand 2010–14

Authors: Dennison A, et al.

Summary: A retrospective chart review of repeat admissions to New Zealand hospitals for acute rheumatic fever from 2010 to 2014 found an overall recurrence rate of 7.2%. A total of 65 episodes of recurrent acute rheumatic fever occurred in 60 patients. All patients were of Māori (51%) or Pacific (49%) ethnicity. Median age at recurrence was 21.6 years, with 83% of recurrences occurring after age 15. The risk of recurrence was 4% for children aged <16 years and increased to 16% for patients aged 16–20 years and 25% for adults aged >20 years. A high proportion of recurrences (73%) occurred in Auckland DHBs. The most common major manifestations of recurrence were arthritis and carditis and recurrence was strongly associated with progression of rheumatic heart disease.

Reference: N Z Med J. 2020;133(1516):47-57.


Privacy Policy: Research Review will record your email details on a secure database and will not release them to anyone without your prior approval. Research Review and you have the right to inspect, update or delete your details at any time. The views expressed in this Publication are personal to the authors, and do not necessarily represent the views or policy of the Ministry of Health on the issues dealt with in the publication.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

Research Review publications are intended for New Zealand health professionals.

Experiences of Māori of Aotearoa New Zealand’s public health system

Authors: Graham R, et al.

Summary: systematic review of 14 published papers spanning two decades of qualitative research investigated the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand. For many Māori, the existing public health system was described as hostile and alienating. Barriers to health included organisational structure, poor staff interactions and practical considerations of cost, transport and time. Facilitators to health included support from whānau members in terms of practical assistance, emotional wellbeing and help navigating the healthcare system.

Comment: One thing that stood out for me here was that whānau were providing so much resource – as practical assistance (travel, care at home, financial), emotional support and navigation. I acknowledge the privilege of caring for whānau with health issues but also want to emphasise that it can also be a burden – on finances, relationships and one’s own health. Please think about ways to mitigate the burden including how we can care for the caregivers.

Reference: Aust N Z J Public Health. 2020;44(3):193-200.


Maori Health Review
Maori Health Review