Rheumatic fever tests are vi­tal

Kapi-Mana News - - OPINION -

The clear­est im­age you should keep in your mind when it comes to rheumatic fever should be a barech­ested Rob­bie Fruean at rugby train­ing.

There is no starker ex­am­ple of the rav­ages of this Third World dis­ease and what ef­fect it can have later in life than the ever- smil­ing Fruean with a huge scar run­ning down the mid­dle of his chest.

The dis­ease – which starts as a cough, de­vel­ops into a strep­to­coc­cal in­fec­tion and can lead to per­ma­nent dam­age to the heart valves – has held the Porirua rugby player back from achiev­ing his All Black dream. He has had heart oper­a­tions and other symp­toms that have in­ter­rupted his ca­reer.

Throat swab­bing and echo screen­ing of chil­dren at about year 7 and 8 be­gan in Porirua in 2012, but was shelved this year by the Health min­istry.

The small num­ber of chil­dren who were di­ag­nosed with rheumatic fever, cou­pled with the pyscho­log­i­cal harm on fam­i­lies when small ab­nor­mal­i­ties were de­tected, were the rea­sons given.

Porirua mayor Nick Leggett and some no­table pae­di­a­tri­cians have been rightly out­raged. Based on the data col­lected from the trial, there could be as many as 200 young peo­ple in the re­gion with un­di­ag­nosed rheumatic fever.

To con­tinue the echo screen­ing will cost about $ 40,000, which seems well worth it when you con­sider the so­cial, per­sonal and eco­nomic cost of one child hav­ing to go through what Fruean did. Or worse.

Porirua has the worst record with rheumatic fever in the de­vel­oped world. It’s a dis­ease that hangs around, largely in eastern Porirua, be­cause of over­crowded liv­ing con­di­tions and sub­stan­dard hous­ing.

Places like Opotiki, South Waikato and Manukau have poor records, but Porirua has con­sis­tently had the worst num­bers of re­ported cases since 1998.

The num­ber of cases in Welling­ton tre­bled be­tween 2004 and 2006, but it took at least six years to ad­dress the is­sue.

At the root of it all is the chil­dren’s liv­ing con­di­tions. Their homes must be made more liv­able and drier.

That’s the am­bu­lance at the top of the cliff.

Half­way down the cliff, as maybe a branch hook­ing the T-shirts of the chil­dren who are con­tract­ing rheumatic fever, is the echo screen­ing and the throat swab­bing.

Caught at that point, cases can be treated.

Right at the bot­tom of the cliff is the hos­pi­tal sys­tem for the chil­dren whose hearts are dam­aged and who have be­come part of the sys­tem, re­quir­ing surgery, hos­pi­tal stays and the painful flow-on ef­fect that has on fam­i­lies.

The Gov­ern­ment needs to con­tinue up­grad­ing the so­cial hous­ing stock. Bet­ter hous­ing equals health­ier fam­i­lies.

Leggett has sought a re­port from of­fi­cers at Cap­i­tal & Coast Dis­trict Health Board. It will surely con­clude that echo screen­ing for year 7 and 8 chil­dren in Porirua must be sup­ported and funded. The re­port will be worth ev­ery penny.

The ex­cuse that the echo screen­ing can some­times give a ‘‘ false pos­i­tive’’ and pro­vide fam­i­lies with un­nec­es­sary stress is weak. Which par­ent would not want to know ev­ery piece of in­for­ma­tion, good or bad, that was avail­able about their child’s health?

Surely it’s bet­ter to know, than not. In the cir­cum­stances, the cost of con­tin­u­ing the echo pro­gramme is min­i­mal.

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