Say ahhhhh. for sore throats A multi faceted approach aiming to reduce the incidence of Rheumatic Fever in West Auckland school communities. Anne Sisam (Public Health Nurse) & Monique Veza (Health Promoting Schools Advisor) Child & Family Services West
Rheumatic Fever Background New Zealand has higher rates of Rheumatic Fever (RF) than comparable countries. Reducing RF rates for Pacific and Māori children is a key target for the Government and Waitemata DHB. There is an association between Group A streptococcus (Strep A) throat infection and RF. RF can lead to life long health conditions and even mortality. RF has a large impact on the wider whānau and cost to society. Māori & Pacific people have much higher rates of RF compared to European. Acute Rheumatic Fever Admissions by Ethnicity -24 year olds, NZ 6-1 Objectives Risk Factors Age 4-15 Higher deprivation Parental unemployment Overcrowding Substandard housing To develop and implement a school community programme to increase awareness and health literacy around sore throats and RF. To develop and implement a robust school based throat swabbing programme to identify children with positive Group A streptococcus (Strep A) throat infections, improving access to primary healthcare and reducing treatment barriers.
Health check consent form Method Identification of RF priority schools (Based on Ministry of Health RF scores) Surveys, factsheet, presentations, evaluation forms Newspaper articles Developed educational resources RF Chatterbox Educational game for students to play with whānau Baseline Surveys Students Staff Community Education & Evaluation Students Staff Community- parents, local services & agencies, GPs Heart Foundation RF Curriculum units implemented into school plan Keep community informed & address gaps Consent obtained for health checks School based symptomatic throat swabbing programme 3 days a week Run by Public Health Nurse & Health Assistant Display board for schools & community events Weekly Team Meetings Documentation & Ministry of Health reporting of project linked Identify & address issues or trends Review process & implement improvements Treatment barriers identified & addressed Antibiotic compliance monitored Data analysis of project Identification of Strep A throat infection Swabs monitored, positives parents contacted Parents encouraged to take child to GP Follow up phone call to check child has been to GP & correct dose of antibiotics obtained If barriers identified, antibiotics given with instructions (under standing orders)
Results Baseline March 13 September 13 Health Education Results Survey Results September 13 Follow up surveys show an increased awareness of the seriousness of sore throats and health literacy around Rheumatic Fever. Very educational, opened my eyes to the seriousness of this disease - Ranui School Teacher These graphs highlight some of the findings at Ranui School. Further education will be targeted to address the knowledge gaps identified in this recent survey. Symptomatic Throat Swabbing Results 1633 children have been swabbed. 18.7% were positive for Strep A throat infection and were medicated. People in Ranui School Community that think sore throats can be dangerous Students Staff Parents People in Ranui School Community that have heard of Rheumatic Fever Students Staff Parents People in Ranui School Community that think Rheumatic Fever can cause heart damage Staff Parents
Conclusion Key learning to date: To have a successful school swabbing programme it is essential to have a comprehensive health education and promotion component running at the same time as this ensures sustainability in reducing RF. Students enjoying RF educational games at Ranui School Community Health Expo Day To successfully reduce the incidents of RF and increase health literacy of communities it is essential to work in partnership with local healthcare providers and community members. Additional positive outcomes: The robust educational and clinical processes developed are a framework for successful delivery for the wider Waitemata area; ensuring consistency of processes, messages and quality of service. This process has already been shared with ADHB and the wider WDHB Child & Family team. The framework can also be applied to other health priorities in the future. Students healthy messages Future plans: Follow up surveys as part of an ongoing evaluation process each year to identify and address knowledge gaps. Continue ongoing health education & health literacy to raise awareness. Ongoing evaluation of the throat swabbing programme and addressing any identified issues. Regular progress reports back to the school and community. Ongoing collaboration with school, community and local healthcare providers. Celebration of successes. Say ahhhhh...for sore throats!