ArticleThe Lancet regional health. Western Pacific2022
Risk factors for acute rheumatic fever: A case-control study.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Systematic Review of Household Transmission of Strep A: A Potential Site for Prevention That Has Eluded Attention.The Journal of infectious diseases · 2024Pooled it
- Acute Rheumatic Fever Diagnostic Network (ARC Network) clinical recruitment protocol.BMJ open · 2026Article
- Geospatial patterns and socio-environmental factors of household overcrowding in Ethiopia: Evidence from 2019 Ethiopian demographic and health survey data.Scientific reports · 2026Article
- Acute rheumatic fever and rheumatic heart disease.Nature reviews. Disease primers · 2026Review
- The Prevalence of Scabies, Skin Infection and Rheumatic Heart Disease in a Cross-Sectional Study of Tongan Primary School Children.Journal of paediatrics and child health · 2026Article
- Global Burden of Pediatric Cardiovascular Diseases of Congenital and Non-Congenital Trends from 1992 to 2021.Communications medicine · 2026Article
- Article
- Māori and Pacific People's perspectives on Group A Streptococcus vaccine development and delivery in Aotearoa, New Zealand.PLOS global public health · 2026Article
- Review
- "It Can Hurt Your Heart": A Co-Designed Cross-Sectional Survey Exploring Pacific People's Understanding of Rheumatic Fever in Auckland, New Zealand.Healthcare (Basel, Switzerland) · 2025Article
- The economic burden of rheumatic heart disease in the Eastern Mediterranean Region.BMJ global health · 2025Article
- New evidence supports a greater focus on streptococcal skin infections to prevent rheumatic fever.The Medical journal of Australia · 2025Article
- Article
- Epidemiological and Clinical Manifestations of Acute Rheumatic Fever in Far North Queensland, Australia.Pathogens (Basel, Switzerland) · 2025Article
- Exploring How Rheumatic Fever Is Portrayed on TikTok: A Descriptive Content Analysis.International journal of environmental research and public health · 2025Article
- Article
- The roles of immuno-modulator treatment and echocardiographic screening in rheumatic fever and rheumatic heart disease control: research from Aotearoa, New Zealand.Journal of the Royal Society of New Zealand · 2025Review
- Global, Regional, and National Burden of Valvular Heart Disease, 1990 to 2021.Journal of the American Heart Association · 2024Article
- Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia.International journal of environmental research and public health · 2024Article
- Article
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain an inequitable cause of avoidable suffering and early death in many countries, including among Indigenous Māori and Pacific populations in New Zealand. There is a lack of robust evidence on interventions to prevent ARF. This study aimed to identify modifiable risk factors, with the goal of producing evidence to support policies and programs to decrease rates of ARF. Methods: A case-control study was undertaken in New Zealand using hospitalised, first episode ARF cases meeting a standard case-definition. Population controls (ratio of 3:1) were matched by age, ethnicity, socioeconomic deprivation, location, sex, and recruitment month. A comprehensive, pre-tested questionnaire was administered face-to-face by trained interviewers. Findings: The study included 124 cases and 372 controls. Multivariable analysis identified strong associations between ARF and household crowding (OR 3·88; 95%CI 1·68-8·98) and barriers to accessing primary health care (OR 2·07; 95% CI 1·08-4·00), as well as a high intake of sugar-sweetened beverages (OR 2·00; 1·13-3·54). There was a marked five-fold higher ARF risk for those with a family history of ARF (OR 4·97; 95% CI 2·53-9·77). ARF risk was elevated following self-reported skin infection (aOR 2·53; 1·44-4·42) and sore throat (aOR 2·33; 1·49-3·62). Interpretation: These globally relevant findings direct attention to the critical importance of household crowding and access to primary health care as strong modifiable causal factors in the development of ARF. They also support a greater focus on the role of managing skin infections in ARF prevention. Funding: This research was funded by the Health Research Council of New Zealand (HRC) Rheumatic Fever Research Partnership (supported by the New Zealand Ministry of Health, Te Puni Kōkiri, Cure Kids, Heart Foundation, and HRC) award number 13/959.
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Registered trials
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