Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia

Ralph, Anna P.; Kelly, Angela M.; Lee, Anne-Marie; Mungatopi, Valerina; Babui, Segora  R.; Budhathoki, Nanda Kaji; Wade, Vicki; Dassel, Jessica L. de; Wyber, Rosemary

doi:10.3390/ijerph191610215

Cited by 6 publications

(16 citation statements)

References 34 publications

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“…Although the contribution of environmental and fomite transmission is less well characterized, recent invasive GAS outbreaks in subacute healthcare settings 140,141 and scarlet fever outbreaks in school-based surveillance settings 142 suggest that fomite-mediated, aerosol and household-mediated transmission contributes to the spread of disease, resulting in GAS clones which in some settings can persist and become dominant 141 . These findings indicate that GAS disease outbreaks are typically not of single point source, highlighting the need for intervention strategies that aim to reduce the GAS burden at the primary sites of infection (throat and skin) in addition to primordial prevention initiatives aimed at increasing health education, improving hygiene practices and improving housing conditions, especially within settings of social disadvantage 143 .…”

Section: Gas Epidemiology and Evolutionmentioning

confidence: 99%

Pathogenesis, epidemiology and control of Group A Streptococcus infection

et al. 2023

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Streptococcus pyogenes (Group A Streptococcus; GAS) is exquisitely adapted to the human host, resulting in asymptomatic infection, pharyngitis, pyoderma, scarlet fever or invasive diseases, with potential for triggering post-infection immune sequelae. GAS deploys a range of virulence determinants to allow colonization, dissemination within the host and transmission, disrupting both innate and adaptive immune responses to infection. Fluctuating global GAS epidemiology is characterized by the emergence of new GAS clones, often associated with the acquisition of new virulence or antimicrobial determinants that are better adapted to the infection niche or averting host immunity. The recent identification of clinical GAS isolates with reduced penicillin sensitivity and increasing macrolide resistance threatens both frontline and penicillin-adjunctive antibiotic treatment. The World Health Organization (WHO) has developed a GAS research and technology road Surface-bound virulence factors M protein. GAS is classified based on the sequence of the 5′ end of the gene encoding the M protein (emm). More than 220 emm genotypes have been identified 2 . The M protein is a dimeric coiled-coil fibrillar protein that extends from the bacterial cell wall 38 . It consists of a conserved Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author selfarchiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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Section: Gas Epidemiology and Evolutionmentioning

confidence: 99%

Pathogenesis, epidemiology and control of Group A Streptococcus infection

et al. 2023

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“…Subsequently, 7 studies describing disease incidence or prevalence outcomes were included in the analysis (Table 1 ). 22 , 23 , 24 , 25 , 26 , 27 , 28 …”

Section: Resultsmentioning

confidence: 99%

Preventive Interventions to Reduce the Burden of Rheumatic Heart Disease in Populations at Risk: A Systematic Review

Shimanda,

Shumba,

Brunström

et al. 2024

JAHA

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Background Rheumatic heart disease (RHD) is a devastating yet preventable condition that disproportionately affects low‐middle–income countries and indigenous populations in some high‐income countries. Various preventive interventions have been implemented across the globe, but evidence for the effectiveness of these measures in reducing the incidence or prevalence of acute rheumatic fever and RHD is scattered. This systematic review aims to assess the effectiveness of preventive interventions and identify the strategies used to reduce the burden of RHD. Methods and Results A comprehensive search was conducted to identify relevant studies on RHD prevention interventions including interventions for primordial, primary, and secondary prevention. Effectiveness measures for the interventions were gathered when available. The findings indicate that school‐based primary prevention services targeting the early detection and treatment of Group A Streptococcus pharyngitis infection with penicillin have the potential to reduce the incidence of Group A Streptococcus pharyngitis and acute rheumatic fever. Community‐based programs using various prevention strategies also reduced the burden of RHD. However, there is limited evidence from low‐middle–income countries and a lack of rigorous evaluations reporting the true impact of the interventions. Narrative synthesis was performed, and the methodological quality appraisal was done using the Joanna Briggs Institute critical appraisal tools. Conclusions This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A Streptococcus pharyngitis, acute rheumatic fever, and RHD. Rigorous evaluations and comprehensive analyses of interventions are necessary for guiding effective strategies and informing public health policies to prevent and reduce the burden of these diseases in diverse populations. Registration URL: https://www.crd.york.ac.uk/prospero/ ; Unique identifier: CRD42020170503.

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“…Primordial prevention of ARF and RHD comprises measures aimed at improving the environmental, social, and economic conditions of people at risk and eliminating exposure to socioeconomic and environmental risk factors ( 50 – 52 ). ARF and RHD are often referred to as “diseases of poverty”.…”

Section: Resultsmentioning

confidence: 99%

“…ARF and RHD are often referred to as “diseases of poverty”. Environmental factors such as overcrowded homes and inadequate sanitation are fundamental reasons for the recurrence of GAS infections in childhood, while socioeconomic factors such as lack of medical resources, inadequate nutrition, unemployment, low income, overall socioeconomic status, low educational level, and social status are factors that contribute to the occurrence of ARF and RHD ( 52 ). Thus, primordial prevention refers to reducing the incidence of GAS infection, ARF, and RHD through interventions that target socioeconomic or environmental factors.…”

Section: Resultsmentioning

confidence: 99%

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

Liang

et al. 2023

Front. Cardiovasc. Med.

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IntroductionThe incidences of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), which were leading causes of death in children in the 1920s, have decreased substantially. Considering the recent resurgence of scarlet fever and increased incidence of streptococcal pharyngitis in children, an investigation of the current status of ARF and RHD may be worthwhile.ObjectiveTo summarize the prevalence trends, pathogenic factors, and prevention strategies for ARF and RHD in children.MethodsA selective search of literature published between January 1920 and February 2023 was done in PubMed, using the terms “acute rheumatic fever”, “rheumatic heart disease”, “group A Streptococcus”, “pharyngitis”, “pharyngeal tonsillitis”, “scarlet fever”, “impetigo”, “obstructive sleep apnea syndrome” and “child”.ResultsOvercrowded homes and inadequate sanitation led to recurrent group A streptococcal infection, and the causal relationship between group A streptococcal infection and ARF/RHD was well established. Streptococcal infectious diseases, such as group A streptococcal pharyngeal tonsillitis, SF, impetigo, and obstructive sleep apnea syndrome, were associated with the occurrence of ARF and RHD. ARF and RHD were still prevalent in young people of developing countries and economically poor populations of high-income countries. Universal disease registration systems were critical to locating disease outbreaks, tracking disease transmission, and identifying high-risk populations. Four-level prevention strategies were effective in reducing the incidence and mortality of ARF and RHD.ConclusionsRegistry and preventive measures for ARF and RHD should be strengthened in areas of dense population; poor sanitation; resurgence of SF; and high incidence of streptococcal pharyngitis, impetigo, and obstructive sleep apnea syndrome.

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Evaluation of a Community-Led Program for Primordial and Primary Prevention of Rheumatic Fever in Remote Northern Australia

Cited by 6 publications

References 34 publications

Pathogenesis, epidemiology and control of Group A Streptococcus infection

Pathogenesis, epidemiology and control of Group A Streptococcus infection

Preventive Interventions to Reduce the Burden of Rheumatic Heart Disease in Populations at Risk: A Systematic Review

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

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