TY - JOUR
T1 - Ethnically disparate disease progression and outcomes among acute rheumatic fever patients in New Zealand, 1989-2015
AU - Oliver, Jane
AU - Robertson, Oliver
AU - Zhang, Jane
AU - Marsters, Brooke L.
AU - Sika-Paotonu, Dianne
AU - Jack, Susan
AU - Bennett, Julie
AU - Williamson, Deborah A.
AU - Wilson, Nigel
AU - Pierse, Nevil
AU - Baker, Michael G.
N1 - This work was supported by a grant from the New Zealand Lotteries Health Commission, in the form of a PhD scholarship awarded to J.O. and a Health Research Council of New Zealand project grant providing support for M.G.B. and J.B. B.M. was supported by a Pacific Health Research Summer Studentship from the Health Research Council of New Zealand. D.A.W. is supported by a Fellowship from the National Health and Medical Research Council of Australia (GNT 1123854).
PY - 2021/6/7
Y1 - 2021/6/7
N2 - We investigated outcomes for patients born after 1983 and hospitalized with initial acute rheumatic fever (ARF) in New Zealand during 1989-2012. We linked ARF progression outcome data (recurrent hospitalization for ARF, hospitalization for rheumatic heart disease [RHD], and death from circulatory causes) for 1989-2015. Retrospective analysis identified initial RHD patients <40 years of age who were hospitalized during 2010-2015 and previously hospitalized for ARF. Most (86.4%) of the 2,182 initial ARF patients did not experience disease progression by the end of 2015. Progression probability after 26.8 years of theoretical follow-up was 24.0%; probability of death, 1.0%. Progression was more rapid and ≈2 times more likely for indigenous Māori or Pacific Islander patients. Of 435 initial RHD patients, 82.2% had not been previously hospitalized for ARF. This young cohort demonstrated low mortality rates but considerable illness, especially among underserved populations. A national patient register could help monitor, prevent, and reduce ARF progression.
AB - We investigated outcomes for patients born after 1983 and hospitalized with initial acute rheumatic fever (ARF) in New Zealand during 1989-2012. We linked ARF progression outcome data (recurrent hospitalization for ARF, hospitalization for rheumatic heart disease [RHD], and death from circulatory causes) for 1989-2015. Retrospective analysis identified initial RHD patients <40 years of age who were hospitalized during 2010-2015 and previously hospitalized for ARF. Most (86.4%) of the 2,182 initial ARF patients did not experience disease progression by the end of 2015. Progression probability after 26.8 years of theoretical follow-up was 24.0%; probability of death, 1.0%. Progression was more rapid and ≈2 times more likely for indigenous Māori or Pacific Islander patients. Of 435 initial RHD patients, 82.2% had not been previously hospitalized for ARF. This young cohort demonstrated low mortality rates but considerable illness, especially among underserved populations. A national patient register could help monitor, prevent, and reduce ARF progression.
U2 - 10.3201/eid2707.203045
DO - 10.3201/eid2707.203045
M3 - Review article
C2 - 34153221
AN - SCOPUS:85108669405
SN - 1080-6040
VL - 27
SP - 1893
EP - 1901
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 7
ER -
