Longitudinal surveillance of group A streptococcal pharyngitis and impetigo in remote Western Australian school children informs acute rheumatic fever prevention
Year: 2025
Type: article
Study design: Observational Study
Abstract: The prevalence of impetigo and pharyngitis - which are both superficial group A streptococcus (GAS) infections that precede acute rheumatic fever - is poorly defined. Guidelines recommend the early diagnosis of both infections to prevent ARF; however, screening to enable the concurrent detection of these infections in high-risk populations has rarely been performed. In this observational cohort study, children attending one of two schools in the remote Kimberley region of Western Australia were assessed for signs and symptoms of impetigo and pharyngitis at repeated screening visits (conducted up to three times per year), and weekly assessments were performed in response to self-reported symptoms. Throat and skin swabs and dried blood spots were collected at screens. Swabs underwent standard microbiological culture and whole genome sequencing was conducted on confirmed GAS isolates. Dried blood spots were assessed for anti-streptococcal antibody titres. A higher-than-anticipated rate of pharyngitis (29.5%), GAS-positive pharyngitis (6.3%) and GAS carriage (9%) was detected, but GAS-positive impetigo was lower (2.6%) compared with previous studies in the Kimberley. Aboriginal and Torres Strait Islander children experienced more GAS infections than did children of other ethnicities, whereas anti-streptococcal antibody titres did not differ according to ethnicity. This study provides evidence to support the need for increased investment and resourcing of ARF primary prevention in the Kimberley, due to high rates of GAS infection.
Source: PLOS Global Public Health
Authors: Janessa Pickering, Dylan D. Barth, Bernadette Wong, Elizabeth McKinnon, Marianne Mullane, Alexandra Whelan, August Mikucki, Rebecca Dalton, Abbey Ford, Gelsa Cinanni, John Joseph, Andrew J. Hayes, Mark R. Davies, Alana Whitcombe, Nicole J. Moreland, Liam Bedford, Scott Winslow, John Jacky, Robyn Macarthur, Shelley Kneebone, Narelle Ozies, Delia Lawford, Jonathan Carapetis, Asha C. Bowen, on Behalf of the Missing Piece Study Surveillance Team
Institutions: The Kids Research Institute Australia, The University of Western Australia, The University of Notre Dame Australia, Pathwest Laboratory Medicine, The University of Melbourne, Peter Doherty Institute, University of Auckland, Maurice Wilkins Centre, Broome Regional Aboriginal Medical Service, Princess Margaret Hospital for Children, Perth Children's Hospital, Charles Darwin University, Menzies School of Health Research
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,496
Funders: Wellcome Trust, Government of Western Australia, Maurice Wilkins Centre for Molecular Biodiscovery, Stan Perron Charitable Foundation, Medical Research Council, National Health and Medical Research Council, Western Australian Future Health and Innovation Fund, Government of Western Australia
Awards: G1400473837, Improving Health Outcomes in the Tropical North: A Multidisciplinary Collaboration, Interventions to eliminate rheumatic heart disease, Healthy Skin and Healthier Lives for Indigenous Australian Children, Wellcome Trust Sanger Institute - generic account for deposition of all core- funded research papers., The END RHD CRE: Developing an endgame for rheumatic heart disease in Australia
OpenAlex ID: W4417507953