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Eradication of rheumatic fever has become a New Zealand health priority in recent years, with the Government investing $65 million across a series of interventions aimed at drastically reducing rheumatic fever incidence by 2017.1 It is possible to prevent rheumatic fever occurrence via the timely treatment of Group-A Streptococcal (GAS) infection with penicillin antibiotics.2 Given that rheumatic fever is primarily a disease of childhood,3'4 the decision to seek care generally rests with someone else-invariably the sick child's parent or caregiver-who will make this decision based on their own experiences and knowledge.
Sore throat awareness, then, is a crucial element of rheumatic fever prevention- part of which is an understanding of the potential consequences of sore throats, and what can be done to prevent them.5 Little is understood about awareness in these respects among those who belong to the highest-risk population.
We interviewed the parents/caregivers of those children who were diagnosed with either definite, probable or possible/ borderline RHD during the recent schoolbased rheumatic heart disease (RHD) echocardiographic screening programmes, conducted in multiple district health boards between 2007-2012 ('case respondents', n=91; age 12.2 years [SD 1.4], 64% of those invited to participate). We also interviewed the parents/caregivers of at least two DHB-matched 'controls' whose scan showed no cardiac abnormality ('control respondents'; n=185, age 11.9 years [SD 1.3], 51% of those invited to participate). Matching solely on study region allowed an approximate match of cases to controls by geographic region, age, socio-economic status and time since the screening event-and, to a lesser extent, ethnicity.
The majority of the screened children were Maori ('abnormal' cases: 52%; 'normal' controls: 56%) or Pacific (cases: 48%; controls: 34%), with a minority being non-Maori/non-Pacific (cases: 5%; controls: 17%). The vast majority of both case (87%) and control (89%) respondents were parents of...