Recurrence rate of streptococcal pharyngitis related to hygienic measures

Falck, Göran; Kjellander, J; Schwan, Anna

doi:10.1080/028134398750003331

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…33 studies reported ARF as the outcome, 27 reported RHD, 10 reported both, and 21 reported GAS infection. There were 16 case control studies, [ 23 – 28 , 32 – 41 ] nine case series, [ 42 – 50 ] 12 cohort studies, [ 5 , 21 , 51 – 61 ] one control trial, [ 62 ] 28 cross section studies, [ 19 , 63 – 89 ] 22 ecologic studies, [ 20 , 90 – 105 ] and three randomised controlled trials (RCT) [ 106 – 108 ]. Studies were conducted in 27 countries with two studies including data from multiple countries.…”

Section: Resultsmentioning

confidence: 99%

“…Three diverse RCTs assessed interventions aimed to induce or reduce acquisition of GAS or its sequelae through common household fomites [ 106 , 108 ] or hygiene practices [ 107 ]. Of these only Luby et al’s (2005) RCT demonstrated an effect on GAS related disease (impetigo).…”

Section: Resultsmentioning

confidence: 99%

“…Further, authors consistently omitted a proposed mechanism to explain their findings. The role of fomites in GAS transmission was not supported [ 106 , 108 ]. Soap and hand-washing had an impressive effect on reducing impetigo, but only one study explored this intervention [ 107 ].…”

Section: Discussionmentioning

confidence: 99%

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The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: A systematic review

2018

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BackgroundRheumatic heart disease (RHD) poses a major disease burden among disadvantaged populations globally. It results from acute rheumatic fever (ARF), a complication of Group A Streptococcal (GAS) infection. These conditions are acknowledged as diseases of poverty, however the role of specific social and environmental factors in GAS infection and progression to ARF/RHD is not well understood. The aim of this systematic review was to determine the association between social determinants of health and GAS infection, ARF and RHD, and the effect of interventions targeting these.MethodologyWe conducted a systematic literature review using PubMed, the Cochrane Library and Embase. Observational and experimental studies that measured: crowding, dwelling characteristics, education, employment, income, nutrition, or socioeconomic status and the relationship with GAS infection, ARF or RHD were included. Findings for each factor were assessed against the Bradford Hill criteria for evidence of causation. Study quality was assessed using a standardised tool.Principle findings1,164 publications were identified. 90 met inclusion criteria, comprising 91 individual studies. 49 (50.5%) were poor quality in relation to the specific study question. The proportion of studies reporting significant associations between socioeconomic determinants and risk of GAS infection was 57.1%, and with ARF/RHD was 50%. Crowding was the most assessed factor (14 studies with GAS infection, 36 studies with ARF/RHD) followed by socioeconomic status (6 and 36 respectively). The majority of studies assessing crowding, dwelling characteristics, education and employment status of parents or cases, and nutrition, reported a positive association with risk of GAS infection, ARF or RHD. Crowding and socioeconomic status satisfactorily met the criteria of a causal association. There was substantial heterogeneity across all key study aspects.ConclusionThe extensive literature examining the role of social determinants in GAS infection, ARF and RHD risk lacks quality. Most were observational, not interventional. Crowding as a cause of GAS infection and ARF/RHD presents a practical target for prevention actions.

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