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Scabies is strongly associated with acute rheumatic fever in a cohort study of Auckland children

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From Māori Health Review Issue 74
Authors:
  • Thornley S et al.
Summary:

This analysis of data from the Auckland Regional Dental Service (ARDS) involved 213,957 children aged 3–12 years attending the ARDS for the first time who were free of rheumatic heart disease at baseline. Over a mean 5.1 years of follow-up, there were 440 hospital diagnoses of ARF or chronic rheumatic heart disease (CRHD). Children diagnosed with scabies during follow‐up were 23 times more likely to develop ARF or CRHD, compared with children who had no scabies diagnosis. This association persisted in a Cox regression analysis adjusting for potential confounders (adjusted HR 8.98; 95% CI, 6.33 to 20.2). When the analysis was restricted to children hospitalised at least once during follow‐up, the adjusted hazard ratio for the same comparison was 3.43 (95% CI, 1.85 to 6.37).

Comment:
Two important papers here looking at rheumatic fever in Aotearoa. Even though it is not common, the significant disparities in rheumatic fever and heart disease rates between Māori and Pacific people and non-Maori/Pacific are appalling, and reflect badly on NZ’s approach to the wellbeing of Māori and Pacific children. Both papers offer potential solutions: a housing review for children presenting to hospital; and diagnosing/treating scabies.
Reference: J Paediatr Child Health. 2018;54(6):625-32
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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