Source: Northland District Health Board, 30 September
Northland DHB is seeing positive results from a campaign to get
children treated for Strep Throat A. First-time episodes of
rheumatic fever have dropped from 15 in 2014 to five cases in 2015
and in 2016 just one case was reported.
It is likely that the focus on early identification and
management of strep throat, much greater access for children at
risk to free treatment via schools and pharmacies, and an extensive
national and regional communications strategy have contributed to
the recent decline.
The school-based throat swabbing programme in all schools decile
1-4 in Northland is delivered by non-government organisation
providers along with Public Health nurses providing opportunistic
throat swabbing in schools, rapid response clinics in three
pharmacies, free GP services for under 13 year olds, and the Sore
Throats Matter publicity campaign.
Northland's Medical Officer of Health Dr Clair Mills says the
throat-swabbing projects were set up to combat rheumatic fever in
"As well as a reduction in the number of new cases of rheumatic
fever, we see that families are more aware of the importance of
treating sore throats and preventing rheumatic fever. However,
there is no room for complacency because many of the risk factors
that contribute to rheumatic fever, such as poor housing, still
exist in Northland."
The School Based throat swabbing programme is delivered by Māori
Health Providers Hokianga Health, iMoko, Te Hau Ora O Ngapuhi, Te
Rūnanga O Whaingaroa, Ki A Ora Ngātiwai and Ngāti Hine Health
Schools are chosen on the basis of historically high numbers of
rheumatic fever. Community health workers visit the schools three
times a week to swab any children with sore throats, and if a child
tests positive for Strep A, a ten day course of antibiotics is
provided free of charge.
"One of the key advantages of the school programmes is that they
are free, universal and don't depend on factors over which children
themselves have no control - such as cost, and the logistics of
getting an appointment and transport to a doctor or nurse," Dr
The comprehensive campaign is all about preventing rheumatic
fever in Northland by curing the Streptococcus bacteria which can
cause the inflammatory disease. The end goal is total eradication
of rheumatic fever in Northland.
"Preventing rheumatic fever not only saves cost to families,
society and the health sector - it represents a better future for
up to twenty young people and their families every year."
Abe Botur, 5, benefited when Northland DHB public health nurses
picked up his Strep Throat infection in early September. Abe had
had a sore throat for two weeks before nurses swabbed his throat at
Whangarei Primary School. His parents were then informed and
Amoxicillin was given to him at school, along with a sticker chart
so Abe could keep track of his ten doses of antibiotic.
These sticker charts have been particularly effective in
increasing rates of adherence, meaning family members ensure the
entire course of antibiotics is taken over the prescribed number of
Abe said his Northland DHB sticker chart, which allowed him to
'wipe out' cartoon germs over ten days, was "Cool" and he enjoyed
filling it up.
Abe said filling up the sticker chart also meant he was allowed
a reward from his "treasure chart box" (sic).
Abe described the Amoxicillin antibiotic as very palatable. "I
fink it was banana…banana milk," Abe said.
Billboards featuring children from local schools have also
proven effective in delivering the Sore Throats Matter message
which urges parents to have their child receive a throat swab via a
nurse or doctor. Those billboards were placed throughout rural
Northland communities such as Kaikohe, Kaeo, Rawene and
Northland DHB has also ensured advertisements in print and on
radio let Northland whānau know tips to keep their homes warm and
dry, as cold, damp and mouldy homes have been linked to rheumatic