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September 20-22, 2017 | Toronto, Canada
10
TH
AMERICAN PEDIATRICS HEALTHCARE &
PEDIATRIC INFECTIOUS DISEASES CONGRESS
Pediatric Healthcare & Pediatric Infections 2017
A
case of acute rheumatic fever (ARF) in an indigenous
maori child in New Zealand Following Group A
Streptococcus (GAS) pyoderma and Group G Streptococcus
pharyngitis is reported. The case demonstrates that ARF can
develop in the absence of GAS pharyngitis and highlights
a need for further research into the role of pyoderma and
non-Group A Streptococci infections in ARF pathogenesis.
This also raises the important question of whether the
appropriateness of tunnel vision best practice. Current
guidelines designed to reduce the overwhelming disparity in
rates of ARF for indigenous Maori and Pasifika children are
focusing solely on GAS pharyngitis as the preceding event
in the development of ARF. If the reliance of evidence from
studies on US servicemen in the 1960’s is not applicable in
these high risk communities of New Zealand and GAS skin
infections have a role then our whole approach needs to
be revisited. This could be an important example of where
health inequities are driven by stubbornly adhering to the
wrong evidence. Dr O’Sullivan will present an example of an
innovative digital healthcare programme iMOKO, developed
to address the issue of GAS skin infections. Since the
introduction of iMOKO there has been a significant reduction
in ARF in children of these communities.
e:
lanceo@imoko.comStreptococcal skin infections and the role in the development of acute rheumatic fever
Lance O Sullivan
University of Auckland, New Zealand