Robust evidence is lacking for community initiatives to prevent first presentation acute rheumatic fever (ARF) by group A streptococcal (GAS) pharyngitis treatment.
We measured the effect of introducing a sore throat clinic program on first presentation ARF into 61 year 1-8 schools with students aged 5-13years (population ~ 25,000) in Auckland, New Zealand. The study period was 2010-2016. A generalized linear mixed model investigated ARF rate changes before and after the staggered introduction of school clinics. Nurses and lay workers treated culture-proven GAS sore throats (including siblings) with 10 days of amoxicillin. ARF cases were identified from a population-based secondary prophylaxis register. Annual pharyngeal GAS prevalence was assessed in a subset.
ARF rates in 5-13 year olds dropped from 88 (95% CI 79, 111)/100,000 pre-clinics to 37 (95% CI 15, 83)/100,000 after 2 years of clinic availability, a 58% reduction.No change in rate was demonstrated before the introduction of clinics (p=0.88, incidence risk ratio (IRR) for a one year change 0.98 (95% CI 0.63, 1.52)) but there was a significant decrease of first presentation ARF rates with time following the introduction of the sore throat program (p=0.008, IRR 0.61 (95% CI 0.43, 0.88)).Pharyngeal GAS cross sectional prevalence fell from 22.4% (16.5, 30.5) pre-intervention to 11.9% (8.6, 16.5) and 11.4% (8.2, 15.7) one and two years later (p=0.005) CONCLUSIONS:: ARF declined significantly following school-based GAS pharyngitis management using oral amoxicillin paralleled by a decline in pharyngeal GAS prevalence.
Pharmacology, Toxicology and Pharmaceutical Science
2
5%
Social Sciences
2
5%
Veterinary Science and Veterinary Medicine
1
3%
Other
6
15%
Unknown
16
41%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 39. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 September 2017.
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#1,055,726
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#186
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#23,742
of 444,905 outputs
Outputs of similar age from The Pediatric Infectious Disease Journal
#2
of 79 outputs
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