Poster Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

Obesity and subsequent weight gain in children hospitalised with acute rheumatic fever (#222)

Jodie Hayward 1 2 , Rachel Webb 1 , Ross Nicholson 1
  1. Kidz First Hospital, Counties Manukau District Health Board, Auckland, New Zealand
  2. Kids First Hospital, Counties Manukau District Health Board, Auckland, New Zealand

Background / Aims

Childhood obesity and acute rheumatic fever (ARF) are significant problems in New Zealand and disproportionately affect children and adolescents of Pacific Island and Māaori ethnicity. Obesity is likely to contribute adversely to long-term cardiac outcomes in this population. Currently, there is no published data on the prevalence of obesity in New Zealand children diagnosed with ARF. Additionally, there is limited published data about benzathine penicillin pharmacokinetics and ARF recurrence rates in obese individuals.

This study aims to describe the prevalence of obesity amongst children hospitalised with ARF and to document their subsequent BMI trajectory and clinical outcomes.


Retrospective observational study of children < 15years admitted to Kidz First Hospital, South Auckland, diagnosed with ARF between 1 January 2007 – 1 January 2012. Cases were identified by ICD codes and included if commenced on benzathine penicillin (BPG) prophylaxis. Detailed review of clinical records up to Jan 2017 was performed.


180 ARF cases were identified over the 5 year study period. Mean age at diagnosis was 9 years 10 months. 60% were male. Two thirds identified as Pacific peoples. Preliminary analysis of the first 79 cases found that at the time of ARF diagnosis, 37/79 (47%) met criteria for obesity (BMI ≥ 97th percentile when corrected for age and gender) and 16/79 (20%) were overweight (BMI 85-95th percentile). Further detailed analysis of clinical outcomes, BMI trajectory, and risk factors for obesity in this population will be presented.