Department of Public Health, University of Otago, Wellington, New Zealand.
Te Kupenga Hauora Māori, The University of Auckland, Auckland, New Zealand.
J Paediatr Child Health. 2021 Jun;57(6):797-802. doi: 10.1111/jpc.15514. Epub 2021 Apr 20.
Rheumatic heart disease (RHD) is a large, preventable, global public health burden. In New Zealand (NZ), acute rheumatic fever (ARF) and RHD rates are highest for Māori and Pacific children. This structured review explores the evidence for primary prevention interventions to diagnose and effectively treat group A Streptococcus (GAS) pharyngitis and skin infections to reduce rates of ARF and RHD. Medline, EMBASE and Scopus databases were searched as well as other electronic publications. Included were 50 publications from 1980 onwards. This review has identified that there is little available evidence for effective primary prevention strategies to reduce ARF rates in NZ. However, two primary intervention strategies that should be considered by communities at high-risk of ARF are: the use of school-based clinics to identify and treat GAS pharyngitis and GAS skin infections; and intramuscular benzathine penicillin G with lignocaine analgesia in children who present with a GAS positive throat.
风湿性心脏病（RHD）是一个庞大的、可预防的全球公共卫生负担。在新西兰（NZ），毛利人和太平洋岛民儿童的急性风湿热（ARF）和 RHD 发病率最高。本系统评价探讨了用于诊断和有效治疗 A 组链球菌（GAS）咽峡炎和皮肤感染以降低 ARF 和 RHD 发病率的一级预防干预措施的证据。检索了 Medline、EMBASE 和 Scopus 数据库以及其他电子出版物。纳入了 1980 年以来的 50 篇出版物。本综述发现，新西兰几乎没有可用于减少 ARF 发病率的有效一级预防策略的证据。然而，对于 ARF 高风险社区，有两种主要的干预策略值得考虑：利用学校诊所来识别和治疗 GAS 咽峡炎和 GAS 皮肤感染；以及在出现 GAS 阳性咽喉的儿童中使用含有利多卡因的肌肉内苄星青霉素 G。
