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Risk factors for acute rheumatic fever: A case-control study
Michael G Baker1,2, Jason Gurney1, Nicole J Moreland3,2
1Department of Public Health, University of Otago, Wellington, New Zealand.
The Lancet Regional Health. Western Pacific
|October 10, 2022
Summary
Household crowding, limited primary healthcare access, and sugary drink consumption are key modifiable risk factors for acute rheumatic fever (ARF). Managing skin and throat infections is also crucial for ARF prevention.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Prevention
Background:
- Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) disproportionately affect Indigenous Māori and Pacific populations in New Zealand.
- There is a critical need for evidence-based interventions to prevent ARF.
- This study sought to identify modifiable risk factors for ARF to inform policy and prevention programs.
Purpose of the Study:
- To identify modifiable risk factors associated with acute rheumatic fever (ARF).
- To provide evidence supporting policies and programs aimed at reducing ARF incidence.
- To understand the causal pathways leading to ARF in a vulnerable population.
Main Methods:
- A case-control study was conducted in New Zealand.
- 124 hospitalized first-episode ARF cases were compared with 372 matched population controls.
- Data were collected via face-to-face interviews using a comprehensive questionnaire.
Main Results:
- Strong associations were found between ARF and household crowding (OR 3.88), barriers to primary healthcare access (OR 2.07), and high sugar-sweetened beverage intake (OR 2.00).
- A family history of ARF significantly increased risk (OR 4.97).
- Self-reported skin infections (aOR 2.53) and sore throats (aOR 2.33) were associated with elevated ARF risk.
Conclusions:
- Household crowding and access to primary healthcare are critical, modifiable causal factors for ARF.
- Managing skin infections is important for ARF prevention strategies.
- These findings have global relevance for ARF prevention efforts.
Keywords:
Acute rheumatic feverCase-control studyCrowdingGroup A streptococcal infectionsHousingMāoriNew ZealandPacific peoplesPrimary healthcareRisk factorsSocial determinantsMore Related Videos
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