Acute Post-Streptococcal Glomerulonephritis in the Northern Territory of Australia: A Review of Data from 2009 to 2016 and Comparison with the Literature

Abstract

Abstract.Acute post-streptococcal glomerulonephritis (APSGN) is an inflammatory kidney disease following infection with nephritogenic strains of Group A Streptococcus. In 1991, APSGN became notifiable in the Northern Territory (NT) of Australia with cases recorded on the NT Notifiable Disease Database (NTNDS). The case definition of a confirmed case requires laboratory definitive evidence or laboratory suggestive evidence in conjunction with a clinically compatible illness. Probable cases require clinical evidence only. Acute post-streptococcal glomerulonephritis notifications from 2009 to 2016 were extracted from the NTNDS. Of the 322 cases, 261 were confirmed and 61 probable. The majority, 304 (94%), were Aboriginal and the median age was 8 years (range: 0–62 years). Incidence for confirmed cases was 13.8/100,000 person-years, with inclusion of probable cases increasing incidence to 17.0/100,000 person-years. Highest incidence of confirmed cases was in Aboriginal children less than 15 years of age at 124.0 cases/100,000 person-years. The rate ratio of confirmed cases in Aboriginal to non-Aboriginal Australians was 18.9 (95% confidence interval: 11.4–33.6). Recent trends show a consistently high number of notifications annually with less frequent outbreaks. The Aboriginal population of the NT continues to have high rates of APSGN with recent trends showing higher rates than previously reported. Sustained preventative efforts and continued surveillance strategies are needed.

Acute post‐streptococcal glomerulonephritis in Central Australia

“…This is in contrast to the general decline in APSGN seen in the developed world . The APSGN incidence of 228.7/100 000 person‐years found in Central Australian children is considerably higher than has been previously reported in the Northern Territory . This study likely underestimates true incidence of APSGN as it reports only hospitalisations.…”

“…APSGN remains an important problem in the Northern Territory where there is an elevated burden of Group A streptococcal disease and chronic kidney disease. 3 This is in contrast to the general decline in APSGN seen in the developed world. 2 The APSGN incidence of 228.7/100 000 person-years found in Central Australian children is considerably higher than has been previously reported in the Northern Territory.…”

“…APSGN remains an important problem in the Northern Territory where there is an elevated burden of Group A streptococcal disease and chronic kidney disease . This is in contrast to the general decline in APSGN seen in the developed world .…”

“…The Northern Territory has one of the highest documented global rates of this disease. The incidence of confirmed APSGN in the Northern Territory is reported to be 17/100 000 person‐years in the general population and 124/100 000 person‐years in Aboriginal children . There are limited data analysing the acute clinical presentation of APSGN, and no studies have described the presentation of APSGN in Central Australia or among Aboriginal people …”

“…The incidence of confirmed APSGN in the Northern Territory is reported to be 17/100 000 person-years in the general population and 124/100 000 person-years in Aboriginal children. 3 There are limited data analysing the acute clinical presentation of APSGN, and no studies have described the presentation of APSGN in Central Australia or among Aboriginal people. [4][5][6][7][8][9][10] The clinical presentation and course of APSGN have been described in Australia in a case series identified in Sydney.…”