AIMS: This study reports acute rheumatic fever (ARF) rates and admission rates for skin infections across the Bay of Plenty from 2000 to 2022 since health initiatives for both commenced in 2011. METHODS: Skin infection hospital admission rates and ARF rates for those under 30 years of age focussed on 2011-2019 after interventions began, compared with 2000-2010. Outcomes/trends were estimated by age bands, ethnicity, gender and socio-economic deprivation. RESULTS: Mean skin infection rates changed very little. However, rates increased between 2000 and 2010 then declined following skin infection programmes' implementation. Comparing 2017-2019 with 2007-2010, skin infection admission rates for Māori declined 40% for preschoolers, 14% for school-age children and 24% for young adults. Inequities persisted. Māori experienced 90% of the ARF (Pacific peoples 6%, NZ Europeans 4%), 80% at school-age. ARF under-30-years-of-age rates 2011-2019 compared with 2000-2010 declined by 29%, with risk ratios of Māori:NZ European 24.33
Māori, High Deprivation:Moderate 3.97 and Male:Female 2.23. School-age ARF rates for Māori declined by 36%. Young adults' ARF rates were unchanged. CONCLUSIONS: While rising skin infection admission rates during the first study period returned to baseline following interventions, ARF declined significantly and contemporaneously for under-30-year-olds and specifically for school-age Māori. Ethnic and socioeconomic disparities persist, needing more concurrent focussed interventions.