Pasifika, Māori prioritised as Govt launches roadmap to tackle rheumatic fever

The Government has announced a five-year focus on tackling rheumatic fever and rheumatic heart disease.

The Rheumatic Fever Roadmap 2023-2028, launched in Ōtara on Tuesday, will help prevent, identify and manage rheumatic fever across Aotearoa, Associate Health Minister Barbara Edmonds says.

Rheumatic fever and rheumatic heart disease are the result of recurring, untreated strep throat or Streptococcal pharyngitis.

Recent studies have found that overcrowded homes raise the risk of acute rheumatic fever – a serious illness that continues to affect Māori and Pacific children.

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One study, released last month, found that up to 1 in 50 young Pasifika adults living in south Auckland may have rheumatic heart disease.

The study by Auckland University and health experts looked at people aged between 16 and 40 years who were enrolled with South Seas Healthcare in Ōtara over a two-year period.

The report was authored by University of Auckland’s Dr Rachel Webb, South Seas Healthcare clinical director Dr Andrew Chan-Mow, Starship Children’s Hospital’s Elizabeth Tilton and Thomas Gentles.

In May, Te Whatu Ora – Health New Zealand announced it had allocated $1m over three years for a rheumatic heart disease pilot programme.

Te Whatu Ora interim director of population health programme commissioning Deborah Woodley said the funding was approved for an echocardiogram-based screening programme, and is expected to start in early 2024.

Edmonds, who is also Minister for Pacific Peoples, said rheumatic fever was an “entirely preventable disease, with Māori and Pacific people, particularly our children and young people, bearing the greatest burden of rheumatic fever which can cause debilitating heart disease.

“Our Pacific people make up 60% of overall rheumatic fever cases with Māori following at 37%. This is in sharp contrast to the rest of the population which represent 3%,” Edmonds said in a statement.

“Despite a decline in hospitalisations, latest data for Auckland indicates that overall rheumatic case numbers have been trending up again post-pandemic… this is worrying for communities,” Edmonds said.

A study by Otago University published in July 2022 had linked household overcrowding to streptococcal infections of the skin.

The study found both illnesses were also associated with barriers to accessing primary healthcare, and with a family history of rheumatic fever and rheumatic heart disease.

One of the studies, drawing on data from 124 cases, also highlighted other risk factors including grandparents of Māori or Pacific ethnicity, high intake of sugar-sweetened beverages, and self-reported skin infections and sore throats.

Edmonds said that, over the past decade, a range of prevention programmes had focused on sore throat management and access to care, healthy housing and raising awareness.

She said there would be a continued priority on those most at risk, “and we also want to see their whānau gain better access to knowledge about prevention and management”.

Edmonds said the roadmap outlined improved access and co-ordination of care, including the transition between paediatric and adult services, reducing barriers for patients, and supporting workforce development.

Rheumatic fever prevention was complex and required a comprehensive response, she said.

“I want to acknowledge everyone who helped develop the roadmap, from academics to health professionals, researchers and whānau who have shared their lived experience.

“Their input has ensured a strong patient, whānau and community focus,” Edmonds said.