Acute rheumatic fever in indigenous children and young adults in Canada: a review of primary prevention strategies
Introduction: There is a growing disparity in the incidence of ARF between Indigenous and non-Indigenous people. ARF is common in school-aged children, particularly those who live in communities with overcrowded housing, poverty, and limited resources. In Manitoba, rates of ARF have greatly declined over the years; however, it continues to disproportionately affect First Nations (FN) people, especially in rural communities. There are currently no national or provincial ARF prevention strategies. Objective: To evaluate primary prevention strategies and programs for ARF targeting Indigenous communities. Methods: A literature review was conducted using the PubMed database for studies and trials. Keywords used were “streptococcal pharyngitis”, “rheumatic fever”, “rheumatic disease”, “primary prevention”. Articles that met the inclusion criteria were selected for review. Results: Five articles were reviewed. All studies utilized school-based sore throat clinics for the detection and diagnosis of streptococcal pharyngitis and subsequent secondary prophylaxis with antibiotics. Four studies found a significant reduction in the incidence of ARF with the schoolbased intervention group to detect and diagnose streptococcal throat infections. Conclusion: Data already exists showing the high incidence of ARF in FN people in Manitoba. School-based programs are effective in reducing the development of ARF. A coordinated effort is urgently needed to implement primary prevention programs in Manitoba.
acute rheumatic fever