Estimating rheumatic fever incidence in New Zealand using multiple data sources

Area of Science:

• Epidemiology
• Public Health
• Infectious Disease Surveillance

Background:

• Rheumatic fever (RF) presents a significant public health challenge in New Zealand.
• Existing RF surveillance data sources in NZ suffer from major limitations, hindering accurate epidemiological assessments.
• This study addresses the need for improved RF incidence estimation due to data deficiencies.

Purpose of the Study:

• To estimate the incidence of Rheumatic Fever (RF) in New Zealand by integrating multiple surveillance data sources.
• To assess the limitations and sensitivities of current RF data collection methods.
• To advocate for the development of a comprehensive national RF surveillance system.

Main Methods:

• Utilized national RF hospitalization and notification data (1988-2011 and 1997-2011).
• Incorporated data from four regional RF registers (Wellington, Waikato, Hawke's Bay, Rotorua).
• Employed capture-recapture analyses with various scenarios to estimate true RF cases (1997-2011) and data source sensitivity.

Main Results:

• An average of 113 new initial Rheumatic Fever (RF) cases were estimated annually.
• Hospitalization data sensitivity was estimated at 80%, while notification data sensitivity was 60%.
• Capture-recapture analysis indicated all regional registers were incomplete.

Conclusions:

• A robust national RF surveillance system, potentially a national register, is crucial for effective disease control in New Zealand.
• Improved surveillance can support targeted strategies and reduce the incidence and impact of Rheumatic Fever.
• Clinicians should remain vigilant for RF cases, including those outside traditionally high-risk demographics.