Virtual Poster 21st Lancefield International Symposium for Streptococci and Streptococcal Diseases 2022

The epidemiology of superficial Streptococcal A (skin and throat) infections in Australia: a systematic review. (#409)

Sophie Wiegele 1 , Elizabeth McKinnon 2 , Bede Van Schaijik 3 , Stephanie Enkel 4 , Katharine Noonan 4 , Asha Bowen 5 6 , Rosemary Wyber 4 7
  1. Clinical Paediatrics, Perth Children's Hospital, Nedlands, WA, Australia
  2. Biometrics, Telethon Kid's Institute, Perth , Western Australia, Australia
  3. University of Western Australia, Perth, Western Australia, Australia
  4. END RHD Program, Telethon Kid's Institute, Perth, Western Australia, Australia
  5. Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kid's Institute, Perth, Western Australia, Australia
  6. Paediatric Infectious Diseases Specialist, Perth Children's Hospital, Perth, Western Australia, Australia
  7. George Institute for Global Health, Sydney, New South Wales, Australia

Australia has a high burden of Streptococcus pyogenes (Strep A, GAS) infections, disproportionately affecting Australian Aboriginal and Torres Strait Islander people. A comprehensive and contemporary understanding of superficial GAS (sGAS) prevalence in both skin and throat disease is essential to address this disparity. A systematic review was conducted to describe the epidemiology of probable sGAS skin and throat infections in Australia between 1970 and 2020. 4889 publications were identified using the previously published search strategy. Of these, 162 proceeded to full text review and 38 publications were included in the final analysis.

 

Subgroup analysis was conducted in two settings: community and healthcare. Estimates of probable sGAS skin infection prevalence within community settings ranged from 5.5 – 66.1% (pooled prevalence of 27.9% [95% CI: 20.0 – 36.5%]), whereas prevalence in healthcare encounters was lower, ranging from 0.1 – 50.0% (pooled prevalence 10.1% [95% CI: 2.9 – 21.0%]). In the community setting prevalence estimates for throat disease ranged from 0.2 – 39.4%, with a pooled estimate of 12.5% [95% CI: 3.5 – 25.9%]. Pooled prevalence amongst health service encounters was much lower at 2.0% [95% CI: 1.3 – 2.8%], ranging from 1.0 – 5.0%.

 

The range of prevalence estimates is indicative of the heterogeneity of the studies included. There was a notable lack of publications in two groups:  skin infection among non-Indigenous populations and throat infection in Australian Aboriginal and Torres Strait Islander people. Data variation suggests that further epidemiological studies focussed on sGAS disease in Australia are needed to inform disease control strategies including vaccine development.