Proteinuria is associated with persistence of antibody to 
streptococcal M protein in Aboriginal Australians

Goodfellow, Alison; Hoy, W. E.; Sriprakash, Kadaba S.; Daly, Michael J.; Reeve, Magnus; Mathews, John D.

doi:10.1017/s0950268898001812

Cited by 16 publications

(10 citation statements)

References 24 publications

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“…Prevalences as high as 70% have been reported for pyoderma in remote Aboriginal communities 1. The major pathogen of pyoderma, group A streptococcus, is associated with chronic renal failure, which is very prevalent in Aboriginal communities 2 3. The high prevalence of pyoderma is also the most likely reason for some Aboriginal communities having the highest reported incidence of acute rheumatic fever worldwide 4…”

Section: Introductionmentioning

confidence: 99%

Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study

Lehmann

Tennant²,

Silva³

et al. 2003

BMJ

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Objective To determine the health impact of swimming pools built with the aim of improving quality of life and reducing high rates of pyoderma and otitis media. Design Intervention study assessing prevalence of ear disease and skin infections before and at six monthly intervals after opening of swimming pools. Setting Two remote Aboriginal communities in Western Australia. Participants 84 boys and 78 girls aged < 17 years. Main outcome measures Changes in prevalence and severity of pyoderma and perforation of tympanic membranes with or without otorrhoea over 18 months after opening of pools. Results In community A, 61 children were seen before the pool was opened, and 41, 46, and 33 children were seen at the second, third, and fourth surveys. Equivalent figures for community B were 60, 35, 39, and 45. Prevalence of pyoderma declined significantly from 62% to 18% in community A and from 70% to 20% in community B during the 18 months after the pools opened. Over the same period, prevalence of severe pyoderma fell from 30% to 15% in community A and from 48% to 0% in community B. Prevalence of perforations of the tympanic membrane fell from 32% in both communities to 13% in community A and 18% in community B. School attendance improved in community A. Conclusion Swimming pools in remote communities were associated with reduction in prevalence of pyoderma and tympanic membrane perforations, which could result in long term benefits through reduction in chronic disease burden and improved educational and social outcomes.

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Section: Introductionmentioning

confidence: 99%

Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study

Lehmann

Tennant²,

Silva³

et al. 2003

BMJ

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“…13,28 The presence of a persistent specific anti-streptococcal antibody, evaluated in a limited number of screened subjects, was also associated with higher levels of proteinuria, with the effect amplified by concurrent overweight or obesity. 29 Lower birth weights, skin sores, scabies, and PSGN are among early-life determinants of kidney disease. Presumably, presence or establishment of an early nephron deficit sets the stage for further cascading nephron loss based on hyperperfusion/hyperfiltration.…”

Section: Discussionmentioning

confidence: 99%

Post-streptococcal glomerulonephritis is a strong risk factor for chronic kidney disease in later life

Hoy

White

Dowling

et al. 2012

Kidney International

152

110

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Although unusual in western countries and in Australia in general, post-streptococcal glomerulonephritis (PSGN) is still common in Australian Aboriginal children living in remote communities. Here, we evaluated whether episodes of acute PSGN increased the risk for chronic kidney disease in later life in 1519 residents of a remote Aboriginal community (85% of those age eligible), with high rates of renal and cardiovascular disease, who participated in a health screen over a 3-year period. Of these, 200 had had at least one episode of PSGN, with 27 having had multiple episodes, usually in childhood. High levels of albuminuria (albumin/creatinine ratio) with increasing age were confirmed. All PSGN episodes were associated with group A streptococcal skin infections, often related to scabies. In both genders, aged 10-39 years at screening, about one in five had such a history. Among them, PSGN (5 years or more earlier) was significantly associated with higher levels of albuminuria than those without. In women, aged 30-39 years, a history of PSGN was associated with a significantly higher frequency of estimated glomerular filtration rates <60 ml/min. The adjusted odds ratios for an albumin/creatinine ratio over 34 g/mol (overt albuminuria) in males and females with a history of PSGN were 4.6 and 3.1, respectively, compared with those without a history. Thus, PSGN contributes to the very serious burden of chronic kidney disease in this community. Rigorous strategies to prevent scabies and Group A streptococcal infections will reduce this burden.

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“…However, there have been reports (424)(425)(426)(427) suggesting that a history of APSGN is an independent and strong risk factor for chronic kidney disease and end-stage renal disease. In the indigenous Australian population, the mean age of onset of overt albuminurea for GAS-seropositive patients is 15 to 30 years earlier than that for GAS-seronegative patients (428), suggesting that past GAS infection is a risk factor for chronic kidney disease in this population.…”

Section: Kidneysmentioning

confidence: 91%

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

et al. 2014

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SUMMARY Streptococcus pyogenes , also known as group A Streptococcus (GAS), causes mild human infections such as pharyngitis and impetigo and serious infections such as necrotizing fasciitis and streptococcal toxic shock syndrome. Furthermore, repeated GAS infections may trigger autoimmune diseases, including acute poststreptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease. Combined, these diseases account for over half a million deaths per year globally. Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host. This improved understanding of the contribution of individual virulence determinants to the disease process has led to the formulation of models of GAS disease progression, which may lead to better treatment and intervention strategies. While GAS remains sensitive to all penicillins and cephalosporins, rising resistance to other antibiotics used in disease treatment is an increasing worldwide concern. Several GAS vaccine formulations that elicit protective immunity in animal models have shown promise in nonhuman primate and early-stage human trials. The development of a safe and efficacious commercial human vaccine for the prophylaxis of GAS disease remains a high priority.

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Proteinuria is associated with persistence of antibody to streptococcal M protein in Aboriginal Australians

Cited by 16 publications

References 24 publications

Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study

Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study

Post-streptococcal glomerulonephritis is a strong risk factor for chronic kidney disease in later life

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

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