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In preparation for the future arrival of a group A Streptococcus (GAS) vaccine, this study estimated the economic and health burdens of GAS diseases in New Zealand. The annual incidence of GAS diseases was based on extrapolation of the average number of primary healthcare episodes managed each year in general practices (2014-2016) and on the average number of hospitalizations occurring each year (2005-2014). Disease incidence was multiplied by the average cost of diagnosing and managing an episode of disease at each level of care to estimate the annual economic burden.

Jonathan Jeffrey Carapetis AM Cannon AM MBBS FRACP FAFPHM PhD FAHMS BSc(Hons) BBus PhD Executive Director; Co-Head, Strep A Translation; Co-Founder

Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity

Pregnancy provides an opportunity to strengthen health system responses and address whole-of-life health for women with rheumatic heart disease

increased adherence to penicillin prophylaxis is associated with reduced acute rheumatic fever recurrence and a likely reduction in mortality

This strategy did not improve adherence to rheumatic heart disease secondary prophylaxis within the study time frame.

Population-based primary prevention of ARF through sore throat management may be effective in well-resourced settings like New Zealand

A multifaceted intervention was implemented using quality improvement and chronic care model approaches to improve delivery of penicillin prophylaxis for rheumatic heart disease

Health systems did not meet the needs of pregnant Aboriginal women with rheumatic heart disease

Adequate resources are needed for maintenance of data quality in acute rheumatic fever/ rheumatic heart disease registers to ensure provision of evidence-based care and accurate assessment of program impact.