Burden of Acute Sore Throat and Group A Streptococcal Pharyngitis in School-aged Children and Their Families in Australia

Danchin, Margaret; Rogers, Sarah; Kelpie, Loraine; Selvaraj, Gowri; Curtis, Nigel; Carlin, John B.; Nolan, Terence M.; Carapetis, Jonathan R.

doi:10.1542/peds.2006-3368

Cited by 113 publications

(104 citation statements)

References 29 publications

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“…The most common age group is 5-15 years. 5 Group A streptococci produce suppurative and non-suppurative infections in humans. 6 The suppurative infections include pharyngitis, pyoderma, erysipelas, cellulitis, necrotizing fasciitis, scarlet fever, puerperal sepsis, pneumonia, meningitis and streptococcal toxic shock syndrome.…”

Section: Introductionmentioning

confidence: 99%

4. Pharyngeal carriage of Group A streptococci among school children

Mukundan¹,

Vijayakumar²

2017

JIMD

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Abstract:Objectives: The aims of the study were to determine the pharyngeal carriage rate of Group A streptococci among school children at Thrissur, Kerala and to determine the antibiotic sensitivity pattern of the above isolates. Materials and methods: Throat swabs were collected from a total of 260 asymptomatic children(130 each from rural and urban areas) of eighth and ninth standard classes during a period between July 2012 and July 2013. Presumptively identified Group A Streptococci (GAS/Streptococcus pyogenes) were serogrouped by agglutination tests using specific antisera. Antibiotic sensitivity was performed by disc diffusion method following CLSI guidelines. Results: The GAS carriage rate noted in the study was 23.1%. Carriage distribution was found to be independent of age, sex and locality with more number of cases during winter season. All the isolates were found to be sensitive to Penicillin and Vancomycin. Five isolates each were found to be resistant to Erythromycin and Clindamycin respectively. Inducible Clindamycin resistance was demonstrated in three of them. GAS was isolated from the throat swab of one child with past history of joint pains and another child with past history of skin infection-both of them presently had findings of heart disease. Conclusion: When screened and appropriately treated with antibiotics, carriers can be prevented from spreading streptococcal infections in the school environment and the community. Combined efforts by clinicians, community health personnel and clinical microbiologists are required for the early detection and control of streptococcal infections. .

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Section: Introductionmentioning

confidence: 99%

4. Pharyngeal carriage of Group A streptococci among school children

Mukundan¹,

Vijayakumar²

2017

JIMD

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“…In a cohort study done in Australia, the incidence of pharyngitis caused by GAS in children aged 5 to 12 years was 13 cases per 100 person-years. 1 GAS pharyngitis causes a considerable cost to society; in the United States it is estimated that GAS pharyngitis in children alone costs between $224 and $539 million per year. 2 In addition to the acute symptoms of sore throat, GAS can lead to suppurative sequelae, including peri-tonsillar abscess, and nonsuppurative sequelae, including rheumatic fever, although this complication is rare today in most industrialized countries.…”

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confidence: 99%

Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-analysis

et al. 2014

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BACKGROUND AND OBJECTIVE: Effective management of group A streptococcal (GAS) pharyngitis is hindered by impracticality of the gold standard diagnostic test: throat culture. Rapid antigen diagnostic tests (RADTs) are a promising alternative, although concerns about their sensitivity and specificity, and variation between test methodologies, have limited their clinical use. The objective of this study was to perform a systematic review with meta-analysis of the diagnostic accuracy of RADTs for GAS pharyngitis. METHODS:Medline and Embase from 1996 to 2013 were used as data sources. Of 159 identified studies, 48 studies of diagnostic accuracy of GAS RADTs using throat culture on blood agar as a reference standard were selected. Bivariate random-effects regression was used to estimate sensitivity and specificity with 95% confidence intervals (CIs). Additional meta-analyses were performed for pediatric data. RESULTS:A total of 60 pairs of sensitivity and specificity from 48 studies were included. Overall summary estimates for sensitivity and specificity of RADTs were 0.86 (95% CI 0.83 to 0.88) and 0.96 (95% CI 0.94 to 0.97), respectively, and estimates for pediatric data were similar. Molecular-based RADTs had the best diagnostic accuracy. Considerable variability exists in methodology between studies. There were insufficient studies to allow meta-regression/subgroup analysis within each test type.CONCLUSIONS: RADTs can be used for accurate diagnosis of GAS pharyngitis to streamline management of sore throat in primary care. RADTs may not require culture backup for negative tests in most low-incidence rheumatic fever settings. Newer molecular tests have the highest sensitivity, but are not true point-of-care tests. ABBREVIATIONS CI-confidence interval ELISA-enzyme-linked immunosorbent assay FISH-fluorescence in situ hybridization GAS-group A b-hemolytic streptococcus OIA-optical immunoassay PCR-polymerase chain reaction QUADAS-Quality Assessment of Diagnostic Accuracy Studies RADT-rapid antigen diagnostic test ROC-receiver operating characteristics S-ROC-summary receiver operating characteristics Dr. Lean collected data for the study and drafted the initial manuscript; Dr Arnup carried out the statistical analyses and reviewed and revised the manuscript; Drs Danchin and Steer conceptualized the study, supervised data collection, and critically reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…This figure, derived from an RF registry in the Vanguard community, is extremely low compared with published data, which suggest that sore throat occurs in at least 33% of children/year. [7][8][9] The study used a figure of 15% for the prevalence of group A streptococci in the pharynx; this means that only 1 -2 of every 1 000 children/ year experience a group A streptococcal sore throat (1.3/1 000 child years). Data from other RF-endemic countries suggest a far higher incidence of group A streptococcal sore throat by a factor of over 100 times: 147/1 000 child years in Fiji and up to 950/1 000 child years in India.…”

Section: Primary Prevention Of Rheumatic Fever In Children: Key Factomentioning

confidence: 99%