A decrease in rheumatic fever hospitalisations

In the 12 months ending on 30 June 2022, there were 77 people admitted to hospital for the first time with rheumatic fever (1.5 per 100,000) in New Zealand. This is a decrease from 107 people in the 12 months ending 30 June 2021 (2.1 per 100,000).

First episode rheumatic fever hospitalisations, annual rate per 100,000, New Zealand, 2006/07-2021/22

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from financial years 2006/07 to 2021/22. The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from financial years 2006/07 to 2021/22. The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from financial years 2006/07 to 2021/22.

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from financial years 2006/07 to 2021/22.

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from financial years 2006/07 to 2021/22.

First episode rheumatic fever hospitalisations, annual rate per 100,000, by ethnic group, New Zealand, 2009/10 – 2021/22

The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time between 2009/10 and 2021/22. The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time between 2009/10 and 2021/22. The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time between 2009/10 and 2021/22.

Following a decrease between years 2011 to 2016, there was a stabilisation in the rate of Māori admitted to hospital for the first time with rheumatic fever between 2016/17 and 2020/21. Māori rates have since decreased for 2021/22.

By comparison, there was no change in hospitalisations for Pacific people between 2011 to 2019, however there has been a large decrease in Pacific people admitted to hospital for the first time with rheumatic fever since 2019/20.  

Work is being commissioned to understand the contributing factors that have led to this decrease, largely driven by a reduction in hospitalisations for Pacific people in Counties Manukau. Specifically, it is crucial to understand if this is a true decrease or under-ascertainment due to reduced access to acute care associated with the COVID-19 pandemic and response. In addition, it is important to identify any factors working well at present in rheumatic fever prevention, that can be sustained going forward.

The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time between 2009/10 and 2021/22.

Following a decrease between years 2011 to 2016, there was a stabilisation in the rate of Māori admitted to hospital for the first time with rheumatic fever between 2016/17 and 2020/21. Māori rates have since decreased for 2021/22.

By comparison, there was no change in hospitalisations for Pacific people between 2011 to 2019, however there has been a large decrease in Pacific people admitted to hospital for the first time with rheumatic fever since 2019/20.  

Work is being commissioned to understand the contributing factors that have led to this decrease, largely driven by a reduction in hospitalisations for Pacific people in Counties Manukau. Specifically, it is crucial to understand if this is a true decrease or under-ascertainment due to reduced access to acute care associated with the COVID-19 pandemic and response. In addition, it is important to identify any factors working well at present in rheumatic fever prevention, that can be sustained going forward.

First episode rheumatic fever hospitalisations, rate per 100,000, by age group, 2021/22

  Numbers

Rate per 100,000

0–4 years 0 0.0
5–14 years 59 8.9
15–24 years 7 1.1
25–44 years 9 0.6
45+ years 2 0.1

Rheumatic fever rates in 2021/22 for Health District

The table below details the rheumatic fever rates in 2021 for Health District (formerly District Health Board region).

 

Health District (formerly DHB region) Rate per 100,000
Northland 2.5
Waitemata 0.6
Auckland -
Counties Manukau 4.3
Waikato 2.0
Lakes -
Bay of Plenty 1.5
Hauora Tairāwhiti -
Taranaki -
Hawke’s Bay 3.8
Midcentral 0.0
Whanganui -
Capital & Coast -
Hutt Valley -
Wairarapa -
Southern region 1.1

Where to from here?

In May 2019, the Government allocated $12 million over four years to improve the prevention and management of rheumatic fever, primarily in the Auckland region where most cases occur.  This $12 million is aimed to ensure a balanced mix of rheumatic fever prevention activities to address rheumatic fever and reduce rheumatic fever rates.

Rheumatic fever prevention will also continue to be a focus for the 11 Health Districts with a high incidence of rheumatic fever, having embedded rheumatic fever prevention initiatives into ongoing delivery of services from 1 July 2022.

From 1 July 2022, an investment of $2 million per year for four years was made to develop the national rheumatic fever register/solution. Funding has also been allocated to support Mana Kidz in Counties Manukau.

Development of a 5-year Rheumatic Fever Roadmap is underway which will set out priority actions and opportunities for investment and action in coming years. We anticipate the Roadmap to be published in early 2023.

Download: Download the data tables for first episode rheumatic fever hospitalisations - XLSX, 40 KB

Rates and numbers are available for the New Zealand population, by ethnic group and for district health board. The workbook also includes the data def