BACKGROUND: Acute rheumatic fever (ARF) and its sequelae, chronic rheumatic heart disease, remain important causes of morbidity and mortality worldwide, but there is little recent information about risk factors. The aim of this study was to examine the association between ARF and household crowding in New Zealand between 1996 and 2005. METHODS: This ecologic study used hospitalization data and census data to calculate incidence rates by census area unit (CAU). Rates of ARF were examined in relation to individual factors (age, ethnicity) and area factors based on the CAU of home address (household crowding, New Zealand deprivation index, household income, and proportion of children aged 5-14 years). The multivariate relationship between ARF incidence and CAU-based variables was assessed using a zero-inflated negative binomial model. RESULTS: This study included 1249 new cases of ARF between 1996 and 2005. At the univariate level, ARF rates were associated with household crowding across all age groups and ethnicities. ARF rates were significantly and positively related to household crowding after controlling for age, ethnicity, household income, and the density of children in the neighborhood. The incidence rate ratio was 1.065 (95% confidence interval, 1.052-1.079) for the total population. CONCLUSIONS: In New Zealand, ARF rates are associated with household crowding at the CAU level. This finding supports action to reduce household crowding to improve health and reduce health inequalities. Our conclusion could be further investigated using a case-control study.
BACKGROUND: Acute rheumatic fever (ARF) and its sequelae, chronic rheumatic heart disease, remain important causes of morbidity and mortality worldwide, but there is little recent information about risk factors. The aim of this study was to examine the association between ARF and household crowding in New Zealand between 1996 and 2005. METHODS: This ecologic study used hospitalization data and census data to calculate incidence rates by census area unit (CAU). Rates of ARF were examined in relation to individual factors (age, ethnicity) and area factors based on the CAU of home address (household crowding, New Zealand deprivation index, household income, and proportion of children aged 5-14 years). The multivariate relationship between ARF incidence and CAU-based variables was assessed using a zero-inflated negative binomial model. RESULTS: This study included 1249 new cases of ARF between 1996 and 2005. At the univariate level, ARF rates were associated with household crowding across all age groups and ethnicities. ARF rates were significantly and positively related to household crowding after controlling for age, ethnicity, household income, and the density of children in the neighborhood. The incidence rate ratio was 1.065 (95% confidence interval, 1.052-1.079) for the total population. CONCLUSIONS: In New Zealand, ARF rates are associated with household crowding at the CAU level. This finding supports action to reduce household crowding to improve health and reduce health inequalities. Our conclusion could be further investigated using a case-control study.
Authors: Yvonne Rydin; Ana Bleahu; Michael Davies; Julio D Dávila; Sharon Friel; Giovanni De Grandis; Nora Groce; Pedro C Hallal; Ian Hamilton; Philippa Howden-Chapman; Ka-Man Lai; C J Lim; Juliana Martins; David Osrin; Ian Ridley; Ian Scott; Myfanwy Taylor; Paul Wilkinson; James Wilson Journal: Lancet Date: 2012-05-30 Impact factor: 79.321
Authors: Matthew H Park; Pearly K Pandya; Yuanjia Zhu; Danielle M Mullis; Hanjay Wang; Annabel M Imbrie-Moore; Robert Wilkerson; Mateo Marin-Cuartas; Y Joseph Woo Journal: Cardiovasc Eng Technol Date: 2022-08-08 Impact factor: 2.305
Authors: Nick Wilson; Lucy Telfar Barnard; Jennifer A Summers; G Dennis Shanks; Michael G Baker Journal: Emerg Infect Dis Date: 2012-01 Impact factor: 6.883
Authors: Emmy Okello; Barbara Kakande; Elias Sebatta; James Kayima; Monica Kuteesa; Boniface Mutatina; Wilson Nyakoojo; Peter Lwabi; Charles K Mondo; Richard Odoi-Adome; Freers Juergen Journal: PLoS One Date: 2012-08-27 Impact factor: 3.240