Department of Public Health, University of Otago, Wellington, New Zealand.
Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand.
J Paediatr Child Health. 2021 Sep;57(9):1385-1390. doi: 10.1111/jpc.15664. Epub 2021 Jul 23.
Acute rheumatic fever (ARF) and its sequela rheumatic heart disease (RHD) remain significant causes of morbidity and mortality. In New Zealand, ARF almost exclusively affects Indigenous Māori and Pacific children. This narrative review aims to present secondary interventions to improve early and accurate diagnosis of ARF and RHD, in order to minimise disease progression in New Zealand. Medline, EMBASE and Scopus databases were searched as well as other electronic publications. Included were 56 publications from 1980 onwards. Diagnosing ARF and RHD as early as possible is central to reducing disease progression. Recent identification of specific ARF biomarkers offer the opportunity to aid initial diagnosis and portable echocardiography has the potential to detect undiagnosed RHD in high-risk areas. However, further research into the benefits and risks to children with subclinical RHD is necessary, as well as an economic evaluation.
急性风湿热（ARF）及其后遗症风湿性心脏病（RHD）仍然是发病率和死亡率的重要原因。在新西兰，ARF 几乎仅影响土著毛利人和太平洋岛民儿童。本叙述性综述旨在介绍二级干预措施，以改善 ARF 和 RHD 的早期和准确诊断，从而最大程度地减少新西兰的疾病进展。我们检索了 Medline、EMBASE 和 Scopus 数据库以及其他电子出版物。纳入了自 1980 年以来的 56 篇出版物。尽早诊断 ARF 和 RHD 是减少疾病进展的关键。最近发现的特定 ARF 生物标志物为辅助初始诊断提供了机会，便携式超声心动图有可能在高风险地区发现未诊断的 RHD。然而，需要对患有亚临床 RHD 的儿童的获益和风险进行进一步研究，以及经济评估。
