Environmental and social determinants of acute rheumatic fever: a longitudinal cohort study

J. W. Cannon, M. Abouzeid, N. de Klerk, C. Dibben, J. R. Carapetis, J. M. Katzenellenbogen

Research output: Contribution to journalArticle

Abstract

Acute rheumatic fever (ARF), an auto-immune response to a group A Streptococcus infection and precursor to rheumatic heart disease (RHD), remains endemic in many socio-economically disadvantaged settings. A Global Resolution on ARF and RHD was recently adopted at the 71st World Health Assembly where governments committed to improving efforts to prevent and control ARF and RHD. To inform these efforts, the objectives of this study were to examine associations between childhood ARF in the UK between 1958 and 1969 and a range of environmental and social factors. Of 17 416 children from the nationally representative birth cohort of the National Child Development Study, ARF was reported in 23 children during early childhood (between birth and the 7-year follow-up) and in 29 additional children during middle childhood (between the 7- and 11-year follow-ups). Risk factors associated with ARF in both early and middle childhood were: a large family size; attendance at a private nursery or class; a history of nephritis, kidney or urinary tract infections; and a history of throat or ear infections. Risk factors for ARF in early childhood alone were families with fathers in a professional or semi-professional occupation and families who moved out of their local neighbourhood. Risk factors in late childhood alone included overcrowding and free school meals. These data suggest that prevention strategies in ARF endemic settings may be enhanced by targeting, for example, new members entering a community and children in environments of close contact, such as a nursery or shared bedrooms.

Original languageEnglish
Pages (from-to)e79
JournalEpidemiology and Infection
Volume147
DOIs
Publication statusPublished - 1 Jan 2019

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Rheumatic Fever
Longitudinal Studies
Cohort Studies
Rheumatic Heart Disease
Nurseries
Parturition
Nephritis
Vulnerable Populations
Child Development
Pharynx
Infection
Streptococcus
Occupations
Urinary Tract Infections
Fathers
Ear
Meals
Kidney

Cite this

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abstract = "Acute rheumatic fever (ARF), an auto-immune response to a group A Streptococcus infection and precursor to rheumatic heart disease (RHD), remains endemic in many socio-economically disadvantaged settings. A Global Resolution on ARF and RHD was recently adopted at the 71st World Health Assembly where governments committed to improving efforts to prevent and control ARF and RHD. To inform these efforts, the objectives of this study were to examine associations between childhood ARF in the UK between 1958 and 1969 and a range of environmental and social factors. Of 17 416 children from the nationally representative birth cohort of the National Child Development Study, ARF was reported in 23 children during early childhood (between birth and the 7-year follow-up) and in 29 additional children during middle childhood (between the 7- and 11-year follow-ups). Risk factors associated with ARF in both early and middle childhood were: a large family size; attendance at a private nursery or class; a history of nephritis, kidney or urinary tract infections; and a history of throat or ear infections. Risk factors for ARF in early childhood alone were families with fathers in a professional or semi-professional occupation and families who moved out of their local neighbourhood. Risk factors in late childhood alone included overcrowding and free school meals. These data suggest that prevention strategies in ARF endemic settings may be enhanced by targeting, for example, new members entering a community and children in environments of close contact, such as a nursery or shared bedrooms.",
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Environmental and social determinants of acute rheumatic fever : a longitudinal cohort study. / Cannon, J. W.; Abouzeid, M.; de Klerk, N.; Dibben, C.; Carapetis, J. R.; Katzenellenbogen, J. M.

In: Epidemiology and Infection, Vol. 147, 01.01.2019, p. e79.

Research output: Contribution to journalArticle

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AU - Katzenellenbogen, J. M.

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