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 2018?

In the 12 months ending on 31 December 2018, there were 171 people diagnosed for the first time with rheumatic fever in New Zealand – a rate of 3.6 per 100,000. The rate is now almost at the level seen prior to the beginning of the Rheumatic Fever Prevention Programme (2009/10-2011/12) when there were 177 cases, a rate of 4.0 per 100,000.

First episode rheumatic fever hospitalisations, annual rate per 100,000, New Zealand, 2002–2018

Since 2002 to 2013 there was a steady increase in the rate in rheumatic fever.  There was a drop between 2013 and 2015 but since then there has been a steady increase in 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 2018.

First episode rheumatic fever hospitalisations, annual rate per 100,000, Māori and Pacific people, 2009–2018

Overall rates for Māori have been trending downwards since 2009, although there may be an increase since 2015.  The graph shows that although there was a decrease in rates for Pacific between 2013 and 2015, since 2016, there has been an increase in rates.

Source: National Minimum Dataset

The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time between 2009 and 2018.

By 31 December 2018, rheumatic fever incidence in Māori had fallen by 34 percent from 2009/10–2011/12. There was a 46 percent increase 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 2018 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 108 11.8
15–44 years 59 3.2
45+ years 4 0.2

Source: National Minimum Dataset.

The table below shows the rheumatic fever rates in 2009/10–2011/12 and in 2018 for each district health board.

District health board 2009/10–2011/12 (rate per 100,000) 2018 (rate per 100,000)
Northland 10.5 5.8
Waitemata 2.2 2.5
Auckland 3.3 3.6
Counties Manukau 13.6 14.7
Waikato 3.5 2.5
Lakes 7.8 4.8
Bay of Plenty 3.8 2.6
Hauora Tairāwhiti 8.5 4.2
Hawke's Bay 4.4 2.5
Taranaki 0.9 ­–
MidCentral 1.8
Whanganui 3.2
Capital & Coast 3.1 2.0
Hutt Valley 4.9 2.1
Wairarapa 0 0.0
Southern region 0.5 0.6

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?

Some DHBs continue to make good progress in reducing rheumatic fever. DHBs that have made good progress in rheumatic fever prevention include Northland, Hauora Tairāwhiti, Lakes and Hawke’s Bay 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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