Reducing rheumatic fever

Between 2012 and June 2017, the Better Public Services programme included a target to reduce rheumatic fever by two-thirds to 1.4 cases per 100,000 people.

How did we do?

In the 12 months ending on 31 December 2017, there were 160 people diagnosed for the first time with rheumatic fever in New Zealand.  This represents a 10 percent drop from 177 people in 2012 (4.0 per 100,000) to 160 people (3.4 per 100,000) by 31 December 2017.

First episode rheumatic fever hospitalisations, annual rate per 100,000, New Zealand, 2002-2017

While rates since 2013 have generally trended downwards, close to the goal, the upward spike in 2016 continued in 2017 but at a lesser rate.

Source: National Minimum Dataset

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from 2002 to 2017.

First episode rheumatic fever hospitalisations, annual rate per 100,000, Māori and Pacific people, 2011–2017

Rates for Māori trended down roughly matching the goal in 2015, but have risen slightly in 2016/17. The downward trend for Pacific people reversed in 2015, but plateaued in 2016 with a slight drop in 2017

Source: National Minimum Dataset
Note that the graph shown on this page differs from that shown previously as it only includes financial year data

The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time between 2011 and 2017.

By 31 December 2017, rheumatic fever incidence in Māori had fallen by 28 percent.  There was no change in the incidence of rheumatic fever cases in Pacific people.

The following table shows the numbers and rates of people being admitted to hospital with rheumatic fever for the first time in 2017 by age group. It shows that the majority of cases occur in children less than 14 years old.

Age group Number Rate (per 100,000)
0–14 years 96 10.5
15–44 years 55 3.0
45+ years 9 0.5

Source: National Minimum Dataset.

The table below details the rheumatic fever rates in 2009/10–2011/12 and in 2017 (the latest available data).

District health board 2009/10–2011/12 (rate per 100,000) 2017 (rate per 100,000)
Northland 10.5 3.5
Waitemata 2.2 1.8
Auckland 3.3 4.0
Counties Manukau 13.6 10.2
Waikato 3.5 4.5
Lakes 7.8 3.8
Bay of Plenty 3.8 3.5
Hauora Tairāwhiti 8.5 6.3
Taranaki 0.9
Hawke's Bay 4.4 2.5
MidCentral 1.8 1.7
Whanganui 3.2 6.4
Capital & Coast 3.1 2.0
Hutt Valley 4.9 5.5
Wairarapa 0 0
Southern region  0.5 0.9

Source: National Minimum Dataset

Note: Rates have not been calculated where there were fewer than four cases. This is because the small numbers will result in unreliable estimates of rates.

Where to from here?

Although the national decrease did not meet the two-thirds reduction target, some DHBs have made good progress in reducing rheumatic fever.  Northland DHB has achieved its target to reduce rheumatic fever by two-thirds. Other DHBs that have made good progress in rheumatic fever prevention include Counties Manukau, Hauora Tairāwhiti, Lakes, Hawke’s Bay and Capital & Coast DHBs.

Rheumatic fever prevention will continue to be a focus for the 11 DHBs with a high incidence of rheumatic fever.

The government has allocated $5 million per year until 2022 to these 11 DHBs so they can continue to deliver a balanced mix of rheumatic fever prevention activities to address rheumatic fever and reduce rheumatic fever rates.

Downloads

You can download the data tables for first episode rheumatic fever hospitalisations. Rates and numbers are available for the New Zealand population, by ethnic group and for district health board. The workbook also includes the data definition that is used to calculate first episode rheumatic fever hospitalisations.

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