Systematic review of rheumatic heart disease prevalence in children in developing countries: The role of environmental factors

Steer, A.; Carapetis, Jonathan R.; Nolan, Terence M.; Shann, Frank

doi:10.1046/j.1440-1754.2002.00772.x

Cited by 139 publications

(120 citation statements)

References 35 publications

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“…mune sequelae, rheumatic heart disease (5,6), and glomerulonephritis (1,7), especially in underdeveloped and developing countries (8), continue to challenge us clinically and scientifically (9,10). GAS expresses an array of surface-bound and secreted proteins, which either alone or in concert play important roles in bacterial adhesion, invasion, and further proliferation in a variety of constantly fluctuating host environments (11).…”

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confidence: 99%

Streptococcus pyogenes Ser/Thr Kinase-regulated Cell Wall Hydrolase Is a Cell Division Plane-recognizing and Chain-forming Virulence Factor

Pancholi

Boël²,

Jin

2010

Journal of Biological Chemistry

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Cell division and cell wall synthesis are closely linked complex phenomena and play a crucial role in the maintenance and regulation of bacterial virulence. Eukaryotic-type Ser/Thr kinases reported in prokaryotes, including that in group A Streptococcus (GAS) (Streptococcus pyogenes Ser/Thr kinase (SP-STK)), regulate cell division, growth, and virulence. The mechanism of this regulation is, however, unknown. In this study, we demonstrated that SP-STK-controlled cell division is mediated under the positive regulation of secretory protein that possesses a cysteine and histidine-dependent aminohydrolases/peptidases (CHAP) domain with functionally active cell wall hydrolase activity (henceforth named as CdhA (CHAP-domain-containing and chain-forming cell wall hydrolase). Deletion of the CdhA-encoding gene resulted in severe cell division and growth defects in GAS mutants. The mutant expressing the truncated CdhA (devoid of the CHAP domain), although displayed no such defects, it became attenuated for virulence in mice and highly susceptible to cell wall-acting antibiotics, as observed for the mutant lacking CdhA. When CdhA was overexpressed in the wild-type GAS as well as in heterologous strains, Escherichia coli and Staphylococcus aureus, we observed a distinct increase in bacterial chain length. Our data reveal that CdhA is a multifunctional protein with a major function of the N-terminal region as a cell division plane-recognizing domain and that of the C-terminal CHAP domain as a virulence-regulating domain. CdhA is thus an important therapeutic target.

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mentioning

confidence: 99%

Streptococcus pyogenes Ser/Thr Kinase-regulated Cell Wall Hydrolase Is a Cell Division Plane-recognizing and Chain-forming Virulence Factor

Pancholi

Boël²,

Jin

2010

Journal of Biological Chemistry

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“…Age-stratified upper-limit-of-normal reference values have been defined for the U.S. pediatric population, the Australian pediatric population, and the Indian pediatric population, among others (5,7,9,11,17). However, there has been no investigation of upper-limit-of-normal values for populations in the Pacific re-gion, where some of the highest rates of acute rheumatic fever and acute post-streptococcal glomerulonephritis are known to occur and where impetigo is common in children (6,21,24).…”

mentioning

confidence: 99%

Normal Ranges of Streptococcal Antibody Titers Are Similar Whether Streptococci Are Endemic to the Setting or Not

Steer

Vidmar

Ritika

et al. 2009

Clin Vaccine Immunol

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Group A streptococcal (GAS) serology is used for the diagnosis of post-streptococcal diseases, such as acute rheumatic fever, and occasionally for the diagnosis of streptococcal pharyngitis. Experts recommend that the upper limits of normal for streptococcal serology be determined for individual populations because of differences in the epidemiology of GAS between populations. Therefore, we performed a study to determine the values of the upper limit of normal for anti-streptolysin O (ASO) and anti-DNase B (ADB) titers in Fiji. Participants with a history of GAS disease, including pharyngitis or impetigo, were excluded. A total of 424 serum samples from people of all ages (with a sample enriched for school-aged children) were tested for their ASO and ADB titers. Reference values, including titers that were 80% of the upper limit of normal, were obtained by regression analysis by use of a curve-fitting method instead of the traditional nonparametric approach. Normal values for both the ASO titer and the ADB titer rose sharply during early childhood and then declined gradually with age. The estimated titers that were 80% of the upper limit or normal at age 10 years were 276 IU/ml for ASO and 499 IU/ml for ADB. Data from our study are similar to those found in countries with temperate climates, suggesting that a uniform upper limit of normal for streptococcal serology may be able to be applied globally.Streptococcal antibody tests are used for the diagnosis of antecedent infections caused by the group A streptococcus (GAS) and are particularly useful for the diagnosis of acute rheumatic fever and acute post-streptococcal glomerulonephritis. Acute rheumatic fever is an autoimmune disease that follows infection with GAS; however, the isolation of GAS is uncommon (Ͻ15%), and so confirmation of the diagnosis often relies on streptococcal antibody tests (13). While a number of tests utilize different antigens of GAS, the most frequently performed tests are those that determine the anti-streptolysin O (ASO) titer and the anti-DNase B (ADB) titer (8,18). Ideally, it is recommended that the titer be determined in the acute phase and then determined in the convalescent phase 14 to 28 days later, with a positive result defined as a rise in titer of twofold or more (26). However, it is not always practicable to obtain a second sample for titer determination, particularly in developing countries, where acute rheumatic fever is the most common. Therefore, it is generally accepted that if only a single specimen is available, a titer greater than the upper limit of normal at the initial testing can be considered presumptive evidence of a preceding streptococcal infection (10, 12, 26).The upper limit of normal for streptococcal serology has been defined by separating the upper 20% from the lower 80% of the group distribution in a dichotomous fashion (4,12,26). The choice of the 80th centile cutoff rather than more traditional upper-limit-of-normal calculations (e.g., 2 standard deviations from the mean) is based upon studies that ...

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“…2,3 In the Top End of the Northern Territory, 2.7% of Aboriginal people have an episode of ARF in their lifetime, compared with 0.014% of the non-Aboriginal population. 4 Primary prophylaxis of ARF, the provision of antibiotics to treat streptococcal pharyngitis, is largely unworkable and unsustainable in high-incidence populations, especially where health services are underresourced.…”

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confidence: 99%

Assessment of a register‐based rheumatic heart disease secondary prevention program in an Australian Aboriginal community

Eissa

Lee

et al. 2005

Australian and New Zealand Journal of Public Health

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A cute rheumatic fever (ARF) and its sequelae are now rare in wealthy industrialised nations.1 Yet, ARF and rheumatic heart disease (RHD) remain important causes of mortality and chronic ill health in poor countries and minority Indigenous populations, such as Aboriginal Australians. 2,3 In the Top End of the Northern Territory, 2.7% of Aboriginal people have an episode of ARF in their lifetime, compared with 0.014% of the non-Aboriginal population. 4 Primary prophylaxis of ARF, the provision of antibiotics to treat streptococcal pharyngitis, is largely unworkable and unsustainable in high-incidence populations, especially where health services are underresourced. 5 Besides, many cases of ARF do not follow clinically identified pharyngitis. Register-based secondary prevention programs can be effective at limiting recurrent ARF and progression to RHD, 7,8 but require early and correct diagnosis of ARF/RHD, followed by long-term administration of an antibiotic (usually benzathine penicillin) on a regular basis. The establishment of a register of patients with known past ARF and/or RHD is the central requirement of a secondary prevention program.9,10 Evaluation of service delivery is regarded as an important part of program design. 11,12A register-based RHD secondary prevention program was established in the Top End of the Northern Territory (NT) in 1997.13 New and recurrent cases of ARF are notif iable in the NT. Clinicians are encouraged to inform the register of all new cases of ARF and newly diagnosed RHD, including 'probable' cases where the diagnosis has not been proven but there is a high index of suspicion. Sources of data for the register include notifications, hospital discharge records, community clinic records, echocardiogram reports and professional correspondence. The register keeps details

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Systematic review of rheumatic heart disease prevalence in children in developing countries: The role of environmental factors

Cited by 139 publications

References 35 publications

Streptococcus pyogenes Ser/Thr Kinase-regulated Cell Wall Hydrolase Is a Cell Division Plane-recognizing and Chain-forming Virulence Factor

Streptococcus pyogenes Ser/Thr Kinase-regulated Cell Wall Hydrolase Is a Cell Division Plane-recognizing and Chain-forming Virulence Factor

Normal Ranges of Streptococcal Antibody Titers Are Similar Whether Streptococci Are Endemic to the Setting or Not

Assessment of a register‐based rheumatic heart disease secondary prevention program in an Australian Aboriginal community

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