Source: New Zealand Herald, 3 January 2018
A first-of-its-kind study
could lead to better treatment for a cruel disease affecting kids
in our poorest, most over-crowded homes.
Acute rheumatic fever is a
complication of a sore throat caused by group A streptococcal
An inflammatory response can
cause joint pain, or rheumatic heart disease, which scars heart
valves and kills about 140 people in New Zealand each year.
The disease is notably
associated with poverty and overcrowded housing and the incidence
is far higher in New Zealand's Maori and Pacific populations than
in other ethnicities.
But a vaccine against the
bacteria infection remains years away.
Until then, the most effective
recommended measure involves painful monthly muscle injections of a
type of penicillin known as benzathine penicillin G, or BPG, for a
decade or longer.
The treatment, also called
secondary prophylaxis, aims to prevent infections that may lead to
the recurrence of rheumatic fever and either cause or worsen
rheumatic heart disease.
But making sure children and
young people received their monthly injections was a challenge,
Otago University medical researcher Dr Dianne Sika-Paotonu said,
and improvements were "urgently needed".
Despite rheumatic fever's toll
in New Zealand and around the world, there was still only limited
data on how the penicillin was working in the people receiving
Early studies to determine how
BPG might work were conducted in healthy, fit, white, young
military recruits aged between 18 and 24 years - none of whom had
rheumatic fever or rheumatic heart disease.
In a new two-year study,
supported with a $250,000 grant from the Health Research Council,
Sika-Paotonu will work with other researchers to look at how
exactly BPG has been working in other groups, including Maori and
The researchers were also
trying to better understand from families and clinicians how its
use might be improved.
Sika-Paotonu said the new
insights would help create a more appropriate form of penicillin
that was hopefully longer acting, less painful and more effective
and suitable for patients.
The team was seeking to
recruit people in the Wellington area, aged between 5 and 21 and
mainly of Maori and Pacific Island descent, receiving injections
for rheumatic fever.
Blood samples would be taken
to help the researchers see how much penicillin entered blood
circulation, and how long it lasted.
"This type of pharmacology
research work would usually require large blood volumes from
participants," Sika-Paotonu said.
"Thanks to research teams in
Australia, this work can now be carried out using finger-prick
samples instead, which is highly preferable to other methods
requiring larger blood volumes in children."
The research was the first BPG
study to focus on young Maori and Pacific Island people. Another
study in Australia was targeting indigenous Aboriginal populations
suffering acute rheumatic fever.
Collectively, she said, the
findings had the potential to influence future medical and public
health recommendations, and contribute to global efforts against