A pilot study to develop assessment tools for Group A Streptococcus surveillance studies

PeerJ

article

Janessa Pickering¹  Claudia Sampson²  Marianne Mullane¹  Meru Sheel³  Dylan D. Barth¹  Mary Lane⁶  Roz Walker⁷  David Atkinson²  Jonathan R. Carapetis¹  Asha C. Bowen¹ 

[1] Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia;School of Medicine, University of Western Australia;Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney;National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University;Faculty of Health and Medical Sciences, The University of Western Australia;Broome Regional Aboriginal Medical Service;School of Population and Global Health, University of Western Australia;Ngank Yira Institute for Change, Murdoch University;Department of Infectious Diseases, Perth Children’s Hospital;Menzies School of Health Research, Charles Darwin University

关键词: Rheumatic fever (RF);    Group A Streptococcus (GAS);    GAS pharyngitis;    GAS impetigo;    GAS skin sores;   

DOI  :  10.7717/peerj.14945

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

IntroductionGroup A Streptococcus (GAS) causes pharyngitis (sore throat) and impetigo (skin sores) GAS pharyngitis triggers rheumatic fever (RF) with epidemiological evidence supporting that GAS impetigo may also trigger RF in Australian Aboriginal children. Understanding the concurrent burden of these superficial GAS infections is critical to RF prevention. This pilot study aimed to trial tools for concurrent surveillance of sore throats and skins sore for contemporary studies of RF pathogenesis including development of a sore throat checklist for Aboriginal families and pharynx photography.MethodsYarning circle conversations and semi-structured interviews were performed with Aboriginal caregivers and used to develop the language and composition of a sore throat checklist. The sore throat story checklist was combined with established methods of GAS pharyngitis and impetigo surveillance (examination, bacteriological culture, rapid antigen detection and serological tests) and new technologies (photography) and used for a pilot cross-sectional surveillance study of Aboriginal children attending their health clinic for a routine appointment. Feasibility, acceptability, and study costs were compiled.ResultsTen Aboriginal caregivers participated in the sore-throat yarning circles; a checklist was derived from predominant symptoms and their common descriptors. Over two days, 21 Aboriginal children were approached for the pilot surveillance study, of whom 17 were recruited; median age was 9 years [IQR 5.5–13.5], 65% were female. One child declined throat swabbing and three declined finger pricks; all other surveillance elements were completed by each child indicating high acceptability of surveillance assessments. Mean time for screening assessment was 19 minutes per child. Transport of clinical specimens enabled gold standard microbiological and serological testing for GAS. Retrospective examination of sore throat photography concorded with assessments performed on the day.ConclusionYarning circle conversations were effective in deriving culturally appropriate sore throat questionnaires for GAS pharyngitis surveillance. New and established tools were feasible, practical and acceptable to participants and enable surveillance to determine the burden of superficial GAS infections in communities at high risk of RF. Surveillance of GAS pharyngitis and impetgio in remote Australia informs primary RF prevention with potential global translation.

【 授权许可】

CC BY