Background
Contemporary data on the global burden of group A Streptococcus (Strep A) pharyngitis are required to understand the frequency of disease and develop value propositions for Strep A vaccines. This systematic review aims to update estimates of the global incidence of Strep A sore throat and describe the heterogeneity in surveillance.
Methods
We used Clarivate Analytics’ Web of Science platform to search for articles published between January 1, 2000, and February 15, 2021, from any country and in any language. We used random-effects meta-analyses to pool sore throat and Strep A sore throat incidence rates from community-based studies. We used the pooled rates and multiplied them by the 2020 global population estimates for children aged 5–14 years to calculate the numbers of episodes occurring due to Strep A sore throat annually.
Results
Of 5,529 articles identified by the search strategy, 26 studies met the inclusion criteria. The pooled incidence rate was 82.2 episodes per 100 child-years (95% confidence interval [CI] = 25.2–286.3, I2 = 100%) for sore throat and 22.1 episodes per 100 child-years (95% CI = 14.7–33.1, I2 = 98%) for Strep A sore throat. We estimated that 288.6 million episodes of Strep A sore throat occurred globally among children in 2020. We also found significant heterogeneity in approaches to disease surveillance for Strep A sore throat across all aspects of study design.
Conclusion
Strep A sore throat has a considerable global burden; standardized surveillance protocols are required to establish robust global burden of disease estimates.