School-based sore-throat swabbing reduced the incidence of first-presentation acute rheumatic fever in a retrospective analysis of Māori schoolchildren in the Bay of Plenty. The incidence of first-presentation acute rheumatic fever was assessed after three interventions in three open cohorts of Māori schoolchildren from 2011 to 2018 and compared with incidences from 2000 to 2010 prior to any intervention. The annual incidence of first-presentation acute rheumatic fever declined by 60% from 148/100,000 to 59/100,000 in Māori schoolchildren in the Eastern Bay rural cohort (mean deprivation decile 9.80), who received school-based sore-throat swabbing with nurse and GP support (p=0.002). Similarly, the annual incidence of first presentation acute rheumatic fever declined by 48% from 50/100,000 to 26/100,000 in Māori schoolchildren in the Western Bay (mean deprivation decile 5.98), who received GP care with school-based sore-throat swabbing in 3 high-risk schools (p=0.044). However, in Māori schoolchildren in Eastern Whakatane township and surrounds (mean deprivation decile 7.25), who received GP management only, the annual incidence of acute rheumatic fever doubled from 30/100,000 to 69/100,000 (p=0.047). Notably, school-based interventions narrowed gender disparities with significant reductions in the incidence of acute rheumatic fever in male Māori schoolchildren.
