auckland’s plan to eliminate arf by 2020

Auckland’s PlanAuckland’s Planto eliminate ARF by 2020to eliminate ARF by 2020

Professor Diana LennonThe University of Auckland

Pharmac7 November 2011

• CMDHBCMDHB• WDHBWDHB• ADHBADHB

School-based RF preventionSchool-based RF preventionClinics : areas withinClinics : areas within

MoH: Local Co-ordinator and Kaiawhina MoH: Local Co-ordinator and Kaiawhina for Tenderfor Tender

Rheumatic FeverRheumatic Feverin in

Auckland register dataAuckland register data(1998-2011)(1998-2011)

Catherine Jackson, Diana LennonPublic Health Medical Registrar

School Scoring (year 1-8)School Scoring (year 1-8)for Clinic Eligibilityfor Clinic Eligibility

• ARF register data (1998→2010) definition assigned by 1 person (Diana Lennon)

• Smoothed CAU rate for ARF: community

• School case density: per Km²

• School decile and proportion of Maori ± Pacific

• MAPPED

Rheumatic Fever in AucklandRheumatic Fever in Auckland

Auckland DHBAuckland DHB

BoardNumber

2006-2010Denom

2006-2010Rate

per 100,00095% CI

Albert-Eden 3 55,090 5.4 0.0-17.0

Otahuhu 2 11,141 18.0 0.7-71.1

Maungakiekie-Tamaki 18 48,291 37.3 23.3-59.6

Orakei 1 49,286 2.0 0.0-13.0

Puketapapa 10 36,061 27.7 14.5-52.1

Waiheke 0 4,870 0.0 0.0-97.9

Waitemata 3 20,670 14.5 3.0-45.4

Whau 3 26,131 11.5 2.4-35.9

ARF in 5-14 year olds in Auckland DHB, 2006-2010

Counties Manukau DHBCounties Manukau DHB

BoardNumber

2006-2010Denom

2006-2010Rate

per 100,00095% CI

Franklin 8 53,917 14.8 7.1-30.0

Franklin (outside Auck) 1 8,648 11.6 0.0-73.9

Howick 3 86,130 3.5 0.7-10.9

Mangere 41 58,889 69.6 51.2-94.8

Manurewa 52 77,352 67.2 51.2-88.4

Otara 24 35,361 67.9 45.3-101.8

Papatoetoe 15 36,776 40.8 24.3-68.2

Papakura 17 34,916 48.7 30.0-78.9

ARF in 5-14 year olds in CMDHB, 2006-2010

Waitemata DHBWaitemata DHB

BoardNumber

2006-2010Denom

2006-2010Rate

per 100,00095% CI

Devonport-Takapuna 0 34,583 0.0 -

Henderson-Massey 27 82,593 32.7 22.3-47.9

Hibiscus and Bays 2 58,715 3.4 0.1-13.5

Kaipatiki 5 53,448 9.4 3.4-22.8

Rodney 3 42,191 7.1 1.5-22.2

Upper Harbour 0 34,676 0.0 -

Waitakere Ranges 5 39,201 12.8 4.6-31.1

Whau 6 21,439 28.0 11.5-63.2

ARF in 5-14 year olds in WDHB, 2006-2010

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Auckland DHB Counties Manukau DHB Waitemata DHB

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Auckland RF ControlAuckland RF Control

• Rollout by suburban hub

Considerations

• PHO/GP partnerships• Community & school messages• Clinics for very high risk schools in clusters• Strategies for medium risk

Staggered rollout will facilitate planned evaluation.

Waitemata DHBTim Jelleyman

Auckland DHBAlison Leversha

Counties Manukau DHBSue MillerDavid Jansen