dc.contributor.author |
Lennon, Diana |
en |
dc.contributor.author |
Anderson, Philippa |
en |
dc.contributor.author |
Kerdemilidis, Melissa |
en |
dc.contributor.author |
Farrell, Elizabeth |
en |
dc.contributor.author |
Crengle Mahi, Suzanne |
en |
dc.contributor.author |
Siatu'u, Teuila |
en |
dc.contributor.author |
Jansen, David |
en |
dc.contributor.author |
Stewart, Joanna |
en |
dc.date.accessioned |
2018-11-01T20:33:57Z |
en |
dc.date.issued |
2017-12 |
en |
dc.identifier.citation |
Pediatric Infectious Disease Journal 36(12):1113-1118 Dec 2017 |
en |
dc.identifier.issn |
0891-3668 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/43731 |
en |
dc.description.abstract |
Robust evidence is lacking for community initiatives to prevent first presentation acute rheumatic fever (ARF) by group A streptococcal (GAS) pharyngitis treatment.We measured the effect of introducing a sore throat clinic program on first presentation ARF into 61-year 1-8 schools with students 5-13 years of age (population ≈25,000) in Auckland, New Zealand. The study period was 2010-2016. A generalized linear mixed model investigated ARF rate changes before and after the staggered introduction of school clinics. Nurses and lay workers treated culture-proven GAS sore throats (including siblings) with 10 days of amoxicillin. ARF cases were identified from a population-based secondary prophylaxis register. Annual pharyngeal GAS prevalence was assessed in a subset.ARF rates in 5-13 year olds dropped from 88 [95% confidence interval (CI): 79-111] per 100,000 preclinics to 37 (95% CI: 15-83) per 100,000 after 2 years of clinic availability, a 58% reduction. No change in rate was demonstrated before the introduction of clinics [P = 0.88; incidence risk ratio for a 1-year change: 0.98 (95% CI: 0.63-1.52)], but there was a significant decrease of first presentation ARF rates with time after the introduction of the sore throat program [P = 0.008; incidence risk ratio: 0.61 (95% CI: 0.43-0.88)]. Pharyngeal GAS cross-sectional prevalence fell from 22.4% (16.5-30.5) preintervention to 11.9% (8.6-16.5) and 11.4% (8.2-15.7) 1 or 2 years later (P = 0.005).ARF declined significantly after school-based GAS pharyngitis management using oral amoxicillin paralleled by a decline in pharyngeal GAS prevalence. |
en |
dc.format.medium |
Print |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
The Pediatric infectious disease journal |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights |
This is a non-final version of an article published in final form in Pediatric Infectious Disease Journal 36(12):1113-1118 Dec 2017 |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
http://www.wkopenhealth.com/Institutions.html |
en |
dc.subject |
Pharynx |
en |
dc.subject |
Humans |
en |
dc.subject |
Streptococcus pyogenes |
en |
dc.subject |
Streptococcal Infections |
en |
dc.subject |
Rheumatic Fever |
en |
dc.subject |
Community-Acquired Infections |
en |
dc.subject |
Amoxicillin |
en |
dc.subject |
Anti-Bacterial Agents |
en |
dc.subject |
Cross-Sectional Studies |
en |
dc.subject |
Primary Prevention |
en |
dc.subject |
Schools |
en |
dc.subject |
Students |
en |
dc.subject |
Adolescent |
en |
dc.subject |
Child |
en |
dc.subject |
Child, Preschool |
en |
dc.subject |
New Zealand |
en |
dc.title |
First Presentation Acute Rheumatic Fever is Preventable in a Community Setting: A School-based Intervention. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1097/inf.0000000000001581 |
en |
pubs.issue |
12 |
en |
pubs.begin-page |
1113 |
en |
pubs.volume |
36 |
en |
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
28230706 |
en |
pubs.end-page |
1118 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
615745 |
en |
dc.identifier.eissn |
1532-0987 |
en |
pubs.record-created-at-source-date |
2017-02-24 |
en |
pubs.dimensions-id |
28230706 |
en |