Structured review of primary interventions to reduce group A streptococcal infections, acute rheumatic fever and rheumatic heart disease

Julie Bennett; Nelly Rentta; William Leung; Anneka Anderson; Jane Oliver; Rosemary Wyber; Matire Harwod; Rachel Webb; John Malcom; Michael G Baker

doi:10.1111/jpc.15514

Structured review of primary interventions to reduce group A streptococcal infections, acute rheumatic fever and rheumatic heart disease

J Paediatr Child Health. 2021 Jun;57(6):797-802. doi: 10.1111/jpc.15514. Epub 2021 Apr 20.

Authors

Julie Bennett¹, Nelly Rentta¹, William Leung¹, Anneka Anderson^{2

3}, Jane Oliver^{4

5}, Rosemary Wyber⁶, Matire Harwod^{7

8}, Rachel Webb^{9

10}, John Malcom¹¹, Michael G Baker¹

Affiliations

¹ Department of Public Health, University of Otago, Wellington, New Zealand.
² Te Kupenga Hauora Māori, The University of Auckland, Auckland, New Zealand.
³ The National Hauora Coalition, Auckland, New Zealand.
⁴ Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
⁵ Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁶ Telethon Kids Institute, Perth, Western Australia, Australia.
⁷ General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
⁸ Papakura Marae Health Clinic, Auckland, New Zealand.
⁹ Auckland District Health Board, Auckland, New Zealand.
¹⁰ Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
¹¹ General Paediatrics, Whakatane Hospital, Whakatane, New Zealand.

PMID: 33876472
DOI: 10.1111/jpc.15514

Abstract

Rheumatic heart disease (RHD) is a large, preventable, global public health burden. In New Zealand (NZ), acute rheumatic fever (ARF) and RHD rates are highest for Māori and Pacific children. This structured review explores the evidence for primary prevention interventions to diagnose and effectively treat group A Streptococcus (GAS) pharyngitis and skin infections to reduce rates of ARF and RHD. Medline, EMBASE and Scopus databases were searched as well as other electronic publications. Included were 50 publications from 1980 onwards. This review has identified that there is little available evidence for effective primary prevention strategies to reduce ARF rates in NZ. However, two primary intervention strategies that should be considered by communities at high-risk of ARF are: the use of school-based clinics to identify and treat GAS pharyngitis and GAS skin infections; and intramuscular benzathine penicillin G with lignocaine analgesia in children who present with a GAS positive throat.

Keywords: GAS; group A Streptococcus; primary prevention; rheumatic fever; rheumatic heart disease.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Child
Humans
New Zealand
Pharyngitis* / drug therapy
Rheumatic Fever* / drug therapy
Rheumatic Fever* / prevention & control
Rheumatic Heart Disease*
Streptococcal Infections* / diagnosis
Streptococcal Infections* / drug therapy
Streptococcal Infections* / prevention & control
Streptococcus pyogenes