Protocol for the systematic review of the epidemiology of superficial Streptococcal A infections (skin and throat) in Australia

Wiegele, Sophie; McKinnon, E.; Wyber, Rosemary; Noonan, Katharine

doi:10.1371/journal.pone.0255789

Cited by 2 publications

(5 citation statements)

References 39 publications

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“…This paper has not included several papers included in past systematic reviews. With reference to the published protocol several articles were reviewed by the research team, given their inclusion in previously published evidence [ 19 ]. Discussion concluded that Shelby et al should be excluded from this analysis as the reported prevalence of impetigo was amongst children already diagnosed with trachoma, potentially confounding prevalence results if children with trachoma were more or less likely to have impetigo [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

“…This systematic review is reported according to the updated Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines [ 16 – 18 ]. The search strategy and review protocol have been published elsewhere, and no amendments have been made [ 19 ]. This review included published and unpublished articles containing epidemiological data (incidence and prevalence) on the clinical presentations of a probable sGAS infection (impetigo/ skin sore/ pyoderma and/or pharyngitis/ tonsillitis) in English from the years 1970–2020 inclusive from Australian settings.…”

Section: Methodsmentioning

confidence: 99%

“…This review executed search strategies through MEDLINE, Scopus, EMBASE, Web of Science, Global Health, Cochrane and CINAHL as well as a comprehensive grey literature search [ 19 ]. The final database search was executed in March 2021.…”

Section: Methodsmentioning

confidence: 99%

“…Extracted data was then compared and discrepancies discussed between the authors. All data points with definitions are described in the protocol paper [ 19 ]. Data collection templates and extracted data are available through contact with the corresponding author (SW).…”

Section: Methodsmentioning

confidence: 99%

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The epidemiology of superficial Streptococcal A (impetigo and pharyngitis) infections in Australia: A systematic review

Wiegele,

McKinnon,

van Schaijik

et al. 2023

PLoS ONE

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Background Streptoccocal A (Strep A, GAS) infections in Australia are responsible for significant morbidity and mortality through both invasive (iGAS) and post-streptococcal (postGAS) diseases as well as preceding superficial (sGAS) skin and throat infection. The burden of iGAS and postGAS are addressed in some jurisdictions by mandatory notification systems; in contrast, the burden of preceding sGAS has no reporting structure, and is less well defined. This review provides valuable, contemporaneous evidence on the epidemiology of sGAS presentations in Australia, informing preventative health projects such as a Streptococcal A vaccine and standardisation of primary care notification. Methods and findings MEDLINE, Scopus, EMBASE, Web of Science, Global Health, Cochrane, CINAHL databases and the grey literature were searched for studies from an Australian setting relating to the epidemiology of sGAS infections between 1970 and 2020 inclusive. Extracted data were pooled for relevant population and subgroup analysis. From 5157 titles in the databases combined with 186 grey literature reports and following removal of duplicates, 4889 articles underwent preliminary title screening. The abstract of 519 articles were reviewed with 162 articles identified for full text review, and 38 articles identified for inclusion. The majority of data was collected for impetigo in Aboriginal and Torres Strait Islander populations, remote communities, and in the Northern Territory, Australia. A paucity of data was noted for Aboriginal and Torres Strait Islander people living in urban centres or with pharyngitis. Prevalence estimates have not significantly changed over time. Community estimates of impetigo point prevalence ranged from 5.5–66.1%, with a pooled prevalence of 27.9% [95% CI: 20.0–36.5%]. All studies excepting one included >80% Aboriginal and Torres Strait Islander people and all excepting two were in remote or very remote settings. Observed prevalence of impetigo as diagnosed in healthcare encounters was lower, with a pooled estimate of 10.6% [95% CI: 3.1–21.8%], and a range of 0.1–50.0%. Community prevalence estimates for pharyngitis ranged from 0.2–39.4%, with a pooled estimate of 12.5% [95% CI: 3.5–25.9%], higher than the prevalence of pharyngitis in healthcare encounters; ranging from 1.0–5.0%, and a pooled estimate of 2.0% [95% CI: 1.3–2.8%]. The review was limited by heterogeneity in study design and lack of comparator studies for some populations. Conclusions Superficial Streptococcal A infections contribute to an inequitable burden of disease in Australia and persists despite public health interventions. The burden in community studies is generally higher than in health-services settings, suggesting under-recognition, possible normalisation and missed opportunities for treatment to prevent postGAS. The available, reported epidemiology is heterogeneous. Standardised nation-wide notification for sGAS disease surveillance must be considered in combination with the development of a Communicable Diseases Network of Australia (CDNA) Series of National Guideline (SoNG), to accurately define and address disease burden across populations in Australia. Trial registration This review is registered with PROSPERO. Registration number: CRD42019140440.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The epidemiology of superficial Streptococcal A (impetigo and pharyngitis) infections in Australia: A systematic review

Wiegele,

McKinnon,

van Schaijik

et al. 2023

PLoS ONE

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“…This difference in data collection may account for some of the discrepancies. We also believe that despite the existing gaps in knowledge, the growing importance of group A Streptococcus (GAS) skin infections as a precipitating factor for ARF in Australia and New Zealand, compared with strep-throat infections as the sole factor in our cases, might explain the differences in the rates of ARF across these case studies 7–9. Additionally, New Zealand only published data for 2 months during the pandemic 6.…”

mentioning

confidence: 92%

Acute rheumatic fever in the province of Manitoba, Canada, before and after the coronavirus (COVID-19) pandemic

Edison,

Pepelassis,

Soni

et al. 2024

Annals of the Rheumatic Diseases

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Protocol for the systematic review of the epidemiology of superficial Streptococcal A infections (skin and throat) in Australia

Cited by 2 publications

References 39 publications

The epidemiology of superficial Streptococcal A (impetigo and pharyngitis) infections in Australia: A systematic review

The epidemiology of superficial Streptococcal A (impetigo and pharyngitis) infections in Australia: A systematic review

Acute rheumatic fever in the province of Manitoba, Canada, before and after the coronavirus (COVID-19) pandemic

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