NZ study links housing to fever

Aworld-first study has uncovered the strongest evidence yet that overcrowded homes raise the risk of acute rheumatic fever — a serious illness that continues to affect Ma¯ori and Pacific children.

Otago University epidemiologist Professor Michael Baker and colleagues have also linked overcrowding to streptococcal skin infections.

Their studies, published in the international medical journal The Lancet

Regional Health — Western Pacific, similarly found both illnesses were also associated with barriers to accessing primary health care, and with a family history of rheumatic fever and rheumatic heart disease.

One of the studies, focused on rheumatic fever and drawing on data from 124 cases, also pinpointed other risk factors including grandparents of any Ma¯ori or Pacific ethnicity; high intake of sugar-sweetened beverages; and self-reported skin infections and sore throats.

The other study, which included data from 733 children and focused on strep skin, also found children with grandparents of any Ma¯ori or Pacific ethnicity were at higher risk, as were those with eczema.

Baker said the findings were a step forward: “Finding a strong association between skin infection and rheumatic fever adds to evidence from other research conducted by our group about the importance of strep skin in triggering this disease.

“These results suggest that treating skin infections in young children may provide a way of preventing them developing rheumatic fever.

“Our findings also reinforce the central role that good quality, uncrowded housing has in protecting children when they are vulnerable to rheumatic fever and other infectious diseases. It is also a reminder of the importance of having good access to primary health care,” Baker said.

Associate Professor Jason Gurney, who had a leading role in the rheumatic fever risk factors study, also emphasised the findings’ importance.

“Rheumatic fever is an important example of the stark inequities that exist in terms of health outcomes in New Zealand,” he said. “Rates of rheumatic fever are around 20 times higher for Ma¯ori and 44 times higher for Pacific peoples than for non-ma¯ ori and non-pacific peoples.”

Gurney said it was vital the new Ma¯ ori Health Authority, Public Health Agency and Health NZ acted on the findings as a high priority.