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Rheumatic fever | Maori children suffer staggering rates

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Pacific children are over 100 times more likely to be hospitalised with acute rheumatic fever (ARF), a Cure Kids’ report finds.

Cure Kids’ 2023 State of Child Health Report found that Pacific and Māori children were 115 and 46 times more likely to be hospitalised with ARF, respectively, compared to the rest of Aotearoa.

They also round rates of hospitalisations for respiratory conditions are higher for Pacific children (2.5 times), followed by Māori children (1.8 times), then Middle Eastern, Latin American, or African (MELAA) children.

Speaking to William Terite on Pacific Mornings, Cure Kids chair of child health research, Stuart Dalziel, said although tamariki Māori (Māori children) are less than half likely to suffer ARF hospitalisation to Pacific children, it remained “unacceptable”.

“The drivers to this I think essentially in terms of rheumatic heart disease (RHD) – our healthcare system is failing tamariki Māori and Pasifika children,” Dalziel said.

“We need to look at the determinants of what makes good health. Those determinants are adequate nutrition, housing, and freedom from poverty.

“Then we need to look at how we’re delivering the care for the children with rheumatic fever and it needs to be in an appropriate manner.”

He said although the figures in the report show progress in combating the disease, there was still room for improvement.

The study also found that 61 per cent of all hospitalisations for ARF or RHD in 2022 were children living in areas with the most socioeconomic deprivation.

“There is certainly a susceptibility and we see this in the Pacific as well but that doesn’t mean that the rates of rheumatic fever should be anywhere near as high as they are,” Dalziel said.

“Our rates of rheumatic fever have reduced a little bit since 2012 but they’re still 60 times more than they should be.

“We need to look at better ways of doing things.”

He said looking into prevention could help, such as having good programmes around throat pain, which is a symptom of rheumatic fever, in schools and pharmacies that are accessible to communities.

Cure Kids detailed five priority areas around hospitable admissions, including respiratory conditions, rheumatic fever and heart disease, skin infections, dental disease, and mental health.

Health Minister and Minister for Pacific Peoples, Dr Shane Reti, said the report was the incentive behind the Pacific Healthy Homes initiative announced a month ago.

The initiative, funded with $4.02 million over the next year and an expansion of the Healthy Homes Initiative and Warmer Kiwi Homes programme, will retrofit 600 Pacific homes.

“Particularly for our frequent flyers, those who frequently attend ED, particularly with ambulatory sensitive hospital conditions,” Reti said.

“Everyone accepts that mouldy, damp homes are a contributor to one, respiratory conditions, and two, conditions like rheumatic fever.”

In terms of prevention and wrap-around support for rheumatic fever, Reti said there were various initiatives, including under 14-year-olds having free GP access, alongside a national coordination strategy.

There is also the Rheumatic Fever Roadmap 2023-2028 announced last year by then-Associate Health Minister Barbara Edmonds, which over five years aims to tackle rheumatic fever and RHD in New Zealand.

“We have different pockets of stuff across the country. We have areas where pharmacies are doing one-stop strep throat shops.

“We have other parts of the country doing other things so these are all being brought together as a national rheumatic fever strategy.”

When asked if Dalziel has confidence in the government’s health response, Reti said that was a difficult question to answer, adding that the government had not “been in the driving seat for long”.

“They’ve suggested we have targets for our health system, one of [them] is that we get 95 per cent of two-year-olds immunised by two years of age.

“When you look at our current rates of that in all children that’s 78 per cent. So, once again we’re failing children miserably

“I think the real crux in terms of the government’s response is whether they can live up to those targets.

“Come back in two years and say ‘we’ve achieved the rates of immunisation’, ‘we’ve lowered the rates of RHD’ and then we can say they have been achieving things appropriately.”

This article was first published by Pacific Media Network (PMN).



Rheumatic fever | Maori children suffer staggering rates

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