None listed
Conditions
Brief summary
The aim of this study is to determine rheumatic fever incidence and management nationally and across four Primary Health Organisations (PHOs): Alliance Health Plus, National Hauora Coalition, Pro Care and Tamaki Health. To measure the size of the problem, secondary analysis of the existing anonymised national, and DHB datasets will be conducted via the National Minimum Dataset. De-identified data will be extracted from four PHOs will be transferred via the University's secure web drop where possible or via an encrypted USB memory stick as a backup. All data will be stored on a secure University of Auckland drive to be analysed (see protocol for further details). De-identified PHO data will include patients who have had a throat/skin swab positive for Group A Strep and/or a rheumatic fever/heart disease diagnosis from 2017-2022. Data will be analysed in R. We will use descriptive epidemiology to determine the incidence of rheumatic fever by ethnicity (Pacific, Maori, and non-Pacific non-Maori) and gender over the past five years. We will also measure the proportion who have had hospitalisations for rheumatic fever and explore the treatment/medication pathways. We will conduct sub-group analyses by age, gender and New Zealand Deprivation Index quintile (NZDep) and time series to determine trends.
Interventions
The aim of this study is to determine the burden of group A streptococcus infections, acute rheumatic fever, and rheumatic heart disease in Auckland practices, comparing Pacific, Maori, and non-Pacific non-Maori groups.
Routinely collected data stored by electronic health records and provided by the four primary health organisations (PHO): Alliance Health Plus, Pro Care, Tamaki Health and National Hauora Coalition data.
To explore these trends, we will use secondary anonymised data from the Na
The aim of this study is to determine the burden of group A streptococcus infections, acute rheumatic fever, and rheumatic heart disease in Auckland practices, comparing Pacific, Maori, and non-Pacific non-Maori groups. Routinely collected data stored by electronic health records and provided by the four primary health organisations (PHO): Alliance Health Plus, Pro Care, Tamaki Health and National Hauora Coalition data. To explore these trends, we will use secondary anonymised data from the National Minimum Dataset, the national collection of hospital discharge information. This will include information of incidence rates for first episode rheumatic fever hospitalisations for each year nationally, by DHB and by prioritised ethnic group. To further explore the burden in Auckland, we will be requesting de-identified, routinely collected clinical data from four PHOs (Alliance Health Plus, National Hauora Coalition, ProCare and Tamaki Health) which comprise the majority of Pasifika and Maori populations in Auckland. Alliance Health Plus is a Pacific-led PHO with approximately 120,000 enrolled patients (28% Pacific, 12% Maori) across 40 general practices while the National Hauora Coalition, a Maori-led PHO, serves around 136,000 patients (14% Pacific, 14% Maori) in 26 clinics. ProCare is a large PHO supporting almost 800,000 patients across Auckland (12.7% Pacific and 9.6% Maori) while Tamaki Health is based in South Auckland and serves 230,000 enrolled patients (33% Pacific and 16% Maori) across 45 general practices. The following variables will be obtained for individual visit data from the PHO: • Patient identifier - All four PHOs will de-identify data and apply codes to replace NHI. • Sex • Date of birth • Ethnicity - prioritised Total Pacific (as a binary variable – any Pacific ethnicity reported Y/N) o Total Tokelauan (ethnicity group Level 2; binary) o Total Niuean (ethnicity group Level 2; binary) o Total Tongan (ethnicity group Level 2; binary) o Total Cook Island Maori (ethnicity group Level 2; binary) o Total Samoan (ethnicity group Level 2; binary) o Total Other Pacific Peoples (ethnicity group Level 2; binary) o Total Pacific Peoples not further defined (ethnicity group Level 2; binary) o Total Fijian (ethnicity group Level 4; binary) o Maori (ethnicity group Level 1; binary) o European (ethnicity group Level 1; binary) o Asian (ethnicity group Level 1; binary) o MELAA (ethnicity group Level 1; binary) • NZ Deprivation (NZDep) index decile • Overall numbers of patients enrolled (and by ethnicity) • Numbers of throat swabs positive for Group A strep • Within cases of positive Group A strep, what was the treatment/management • All notifications of acute rheumatic fever cases • Date of rheumatic fever diagnoses • All cases of rheumatic heart disease • Numbers and dates of prescriptions for related medications (e.g. amoxicillin, penicillin) • Hospital admission(s) with the primary diagnosis of rheumatic fever • Hospital admission(s) with the primary diagnosis of rheumatic heart disease • Date of death The duration of observation is between 31 March 2017 to 1 April 2022.
Sponsors
Dr Siobhan Tu'akoi
Eligibility
Sex/Gender
All
Healthy volunteers
Yes
Inclusion criteria
All patients enrolled with the following four primary health organisations based in Auckland, New Zealand: Alliance Health Plus, National Hauora Coalition, Pro Care, Tamaki Health, from 31 March 2017 to 1 April 2022.
Exclusion criteria
Patients not enrolled at one of the four outlined primary health organisations in Auckland.
Outcome results
None listed