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Volume 27, Number 1—January 2021
CME ACTIVITY - Research

Rising Ethnic Inequalities in Acute Rheumatic Fever and Rheumatic Heart Disease, New Zealand, 2000–2018

Julie BennettComments to Author , Jane Zhang, William Leung, Susan Jack, Jane Oliver, Rachel Webb, Nigel Wilson, Dianne Sika-Paotonu, Matire Harwood, and Michael G. Baker
Author affiliations: University of Otago, Wellington (J. Bennett, J. Zhang, W. Leung, D. Sika-Paotonu, M.G. Baker); Southern District Health Board, Dunedin, New Zealand (S. Jack); University of Melbourne, Melbourne, Victoria, Australia (J. Oliver); Murdoch Children’s Research Institute, Melbourne (J. Oliver); Auckland District Health Board, Auckland, New Zealand (R. Webb, N. Wilson); University of Auckland, Auckland (D. Sika-Paotonu, M. Harwood)

Main Article

Table 1

Acute rheumatic fever initial hospitalizations and adjusted rate ratios for patients <30 years of age, according to key sociodemographic characteristics, New Zealand, 2000–2018*

Category No. cases Crude rate of ARF at initial hospitalization/100,000 population aRR (95% CI) RR in 2010–2018 vs. 2000–2009 (95% CI)
Age†
<5 35 0.62 0.18 (0.13–0.25) 0.42 (0.20–0.88)
5–9 768 13.45 4.10 (3.57–4.70) 1.01 (0.88–1.17)
10–14 1,184 20.55 6.58 (5.77–7.51) 1.08 (0.96–1.21)
15–19 308 5.27 1.81 (1.54–2.13) 1.29 (1.03–1.62)
20–29
 276
 2.27
 Referent
 1.86 (1.45–2.38)
Sex‡
M 1,493 8.60 1.34 (1.24–1.45) 1.09 (0.99–1.21)
F
 1,078
 6.42
 Referent
 1.18 (1.05–1.33)
Ethnicity (prioritized)§
Māori 1257 16.77 11.84 (10.02–13.98) 1.09 (0.98–1.22)
Pacific Islander 1124 38.12 23.57 (19.88–27.94) 1.30 (1.16–1.47)
Asian 23 0.55 0.64 (0.41–0.99) 0.41 (0.18–0.98)
European and other
 167
 0.86
 Referent
 0.61 (0.44–0.84)
Socioeconomic deprivation level¶
1–2 61 1.06 Referent 0.63 (0.38–1.05)
3–4 128 2.16 1.65 (1.21–2.23) 0.85 (0.60–1.20)
5–6 160 2.51 1.60 (1.19–2.25) 0.91 (0.67–1.24)
7–8 405 5.57 2.58 (1.96–3.38) 1.31 (1.08–1.59)
9–10
 1,817
 20.58
 5.21 (4.01–6.75)
 1.16 (1.06–1.27)
District health board#
Northland 206 17.36 7.56 (4.39–13.02) 1.10 (0.84–1.45)
Counties Manukau, South Auckland 909 21.67 7.37 (4.32–12.53) 1.23 (1.08–1.41)
Tairawhiti, Gisborne 63 16.01 5.47(3.06–9.80) 1.45 (0.88–2.39)
South Island, 5 DHBs
 67
 0.91
 Referent
 1.21 (0.71–1.88)
Total 2,571 7.53 1.13 (1.04–1.22)

*An additional 181 (6.6% of total) cases occurred among persons >30 years of age during 2000–2018. aRR, adjusted rate ratio; DHB, district health board; RR, rate ratio.
†RR adjusted for sex, ethnicity, and socioeconomic deprivation.
‡RR adjusted for age, ethnicity, and socioeconomic deprivation.
§RR adjusted for age, sex, and socioeconomic deprivation.
¶RR adjusted for age, sex, and ethnicity.
#RR adjusted for age, sex, ethnicity, and socioeconomic deprivation; 3 DHBs highest incidence and 1 DHB with lowest incidence shown. A full list of DHBs is provided in Appendix Table 1).

Main Article

Page created: November 13, 2020
Page updated: December 18, 2020
Page reviewed: December 18, 2020
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