New research shows household overcrowding and drinking sugar-sweetened drinks could lead to rheumatic fever.
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University of Otago researchers investigated the risk factors for streptococcal infections of the throat and skin, which can cause the autoimmune disease.
Lead researcher Professor Michael Baker said they found both rheumatic fever and strep skin were linked with barriers to accessing primary health care and a family history of rheumatic fever and rheumatic heart disease.
Professor Michael Baker Photo: Supplied / University of Otago
"Finding a strong association between skin infection and rheumatic fever adds to evidence from other research conducted by our group about the importance of strep skin in triggering this disease. These results suggest that treating skin infections in young children may provide a way of preventing them developing rheumatic fever," he said.
"Our findings reinforce the central role that good quality, uncrowded housing has in protecting children during the period when they are vulnerable to rheumatic fever and other infectious diseases. It is also a reminder of the importance of having good access to primary health care."
One unexpected finding was that drinking sugar-sweetened drinks was twice as common among people who had rheumatic fever than those who did not. Researchers were planning to further test this link, Professor Baker said.
Associate Professor Jason Gurney led the rheumatic fever risk factors study. He said the disease was an example of the inequities of health outcomes in New Zealand, with the indigenous and Pacific populations of New Zealand and Australia showing some of the highest rates of rheumatic heart disease in the world.
"Rates of rheumatic fever are around 20 times higher for Māori and 44 times higher for Pacific peoples than for non-Māori and non-Pacific peoples," Gurney said.
"It is vital that the new incoming health organisations, notably the Māori Health Authority, Public Health Agency, and Health New Zealand act on these research findings as a high priority.
"It is also crucial that we look further upstream at the social determinants of this disease and continue to address inequities in access to things like high-quality, healthy housing and primary care."
Dr Julie Bennett who led the strep infection risk factors study said the next step would be to test specific interventions highlighted in the research.
"The findings from these two studies and other related research suggest that skin infection is a key target for better treatment.
"It would be useful to conduct suitable trials to see how better access to effective treatment of skin infections could be delivered most effectively and how this could lower the subsequent risk of rheumatic fever."
She said any interventions would need to be co-designed with Māori and Pacific peoples.