Early cardiac morbidity of rheumatic fever in children in New Zealand.

AIM: The aim of this study was to review the severity and morbidity of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) for children with the most significant cardiac disease in the current era in New Zealand.

METHOD: Retrospective 2-year review of children with ARF and RHD admitted to Starship Children's cardiology ward. Medical and surgical admissions were classified. Echocardiographic severity of cardiac disease and cardiac surgical data were analyzed. Using length of stay data and 2009 District Health Board costings, admission costs were calculated.

RESULTS

36 children had 49 admissions. Mean age 11.8 plus or minus 2.4 years. All but one child was of Māori or Pacific Island ethnicity. 10 children had symptoms and signs of congestive cardiac failure on admission. The average length of stay was 23 days, but the subset of children with ARF requiring cardiac surgery at the same admission had an average of 54 days (range 36-78 days) in hospital. The total hospital costs over the 2-year period was $1,918,600.

CONCLUSION

Failure to prevent rheumatic fever in New Zealand means that there is significant cardiac sequelae for those children who develop severe RHD. The early morbidity includes heart failure, need for cardiac surgery, and prolonged hospital stay.