Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa

Infection with Group A β-haemolytic Streptococcus, also known as Streptococcus pyogenes, results in various mucosal and skin diseases including pharyngitis. An exaggerated immune response to a single or repeated group A streptococcal (GAS) infection subsequently results in acute rheumatic fever (ARF...

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Autores principales:	Mark E. Engel, Bongani M. Mayosi
Formato:	article
Lenguaje:	EN
Publicado:	South African Heart Association 2017
Materias:	streptococcus pyogenes acute rheumatic fever rheumatic heart disease africa Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/b9ff8a1190624e9da05c0cc4736d458c
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spelling	oai:doaj.org-article:b9ff8a1190624e9da05c0cc4736d458c2021-11-29T13:24:36ZClinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa10.24170/10-2-18021996-67412071-4602https://doaj.org/article/b9ff8a1190624e9da05c0cc4736d458c2017-04-01T00:00:00Zhttps://www.journals.ac.za/index.php/SAHJ/article/view/1802https://doaj.org/toc/1996-6741https://doaj.org/toc/2071-4602Infection with Group A β-haemolytic Streptococcus, also known as Streptococcus pyogenes, results in various mucosal and skin diseases including pharyngitis. An exaggerated immune response to a single or repeated group A streptococcal (GAS) infection subsequently results in acute rheumatic fever (ARF) and, in the absence of intervention, repeated bouts of ARF may in turn result in progression to RHD, particularly in those ARF patients with cardiac involvement. Addressing GAS pharyngitis through appropriate primary prevention measures and treating all symptomatic GAS sore throats with a course of oral or parenteral penicillin presents an opportunity for the primary intervention of RHD. Failure to eradicate streptococci from the pharynx occurs in about one third of non-treated cases, giving rise to carrier status in those individuals harbouring intracellular GAS and thus representing a potential source of the acquisition of infections for other children and adults. Improved living conditions and access to healthcare during the last century are credited for the considerable decline in the prevalence of ARF and RHD in developed countries. However, a few studies have been reported from within Africa, and in these GAS carriage ranged around 9.0%. In South African studies GAS carriage isolation rates, which range from 1.62% to16.8%, were reported. As regards the prevalence of GAS pharyngitis, it is generally higher in developing countries and impoverished communities within industrialised nations. The most-up-to-date data from South Africa was collected more than 30 years ago with rates then ranging from 23.2% to 45.5%. There are no incidence data on GAS pharyngitis in Africa. This review found that there is a need to document the epidemiology of GAS carriage and GAS pharyngitis in school children of all ages within Africa. Molecular characterisation of strains harboured in the pharynx of carriers and of those isolated during bouts of pharyngitis, will help to identify risk factors associated with carriage in school-aged children and influence the planning and evaluation of management programmes in the screening of pharyngeal carriers and treatment of GAS pharyngitis.Mark E. EngelBongani M. MayosiSouth African Heart Associationarticlestreptococcus pyogenesacute rheumatic feverrheumatic heart diseaseafricaDiseases of the circulatory (Cardiovascular) systemRC666-701ENSA Heart Journal, Vol 10, Iss 2, Pp 434-439 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	streptococcus pyogenes acute rheumatic fever rheumatic heart disease africa Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	streptococcus pyogenes acute rheumatic fever rheumatic heart disease africa Diseases of the circulatory (Cardiovascular) system RC666-701 Mark E. Engel Bongani M. Mayosi Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa
description	Infection with Group A β-haemolytic Streptococcus, also known as Streptococcus pyogenes, results in various mucosal and skin diseases including pharyngitis. An exaggerated immune response to a single or repeated group A streptococcal (GAS) infection subsequently results in acute rheumatic fever (ARF) and, in the absence of intervention, repeated bouts of ARF may in turn result in progression to RHD, particularly in those ARF patients with cardiac involvement. Addressing GAS pharyngitis through appropriate primary prevention measures and treating all symptomatic GAS sore throats with a course of oral or parenteral penicillin presents an opportunity for the primary intervention of RHD. Failure to eradicate streptococci from the pharynx occurs in about one third of non-treated cases, giving rise to carrier status in those individuals harbouring intracellular GAS and thus representing a potential source of the acquisition of infections for other children and adults. Improved living conditions and access to healthcare during the last century are credited for the considerable decline in the prevalence of ARF and RHD in developed countries. However, a few studies have been reported from within Africa, and in these GAS carriage ranged around 9.0%. In South African studies GAS carriage isolation rates, which range from 1.62% to16.8%, were reported. As regards the prevalence of GAS pharyngitis, it is generally higher in developing countries and impoverished communities within industrialised nations. The most-up-to-date data from South Africa was collected more than 30 years ago with rates then ranging from 23.2% to 45.5%. There are no incidence data on GAS pharyngitis in Africa. This review found that there is a need to document the epidemiology of GAS carriage and GAS pharyngitis in school children of all ages within Africa. Molecular characterisation of strains harboured in the pharynx of carriers and of those isolated during bouts of pharyngitis, will help to identify risk factors associated with carriage in school-aged children and influence the planning and evaluation of management programmes in the screening of pharyngeal carriers and treatment of GAS pharyngitis.
format	article
author	Mark E. Engel Bongani M. Mayosi
author_facet	Mark E. Engel Bongani M. Mayosi
author_sort	Mark E. Engel
title	Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa
title_short	Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa
title_full	Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa
title_fullStr	Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa
title_full_unstemmed	Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa
title_sort	clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in africa
publisher	South African Heart Association
publishDate	2017
url	https://doaj.org/article/b9ff8a1190624e9da05c0cc4736d458c
work_keys_str_mv	AT markeengel clinicalandepidemiologicalaspectsofstreptococcuspyogenespharyngitisandcarriageinafrica AT bonganimmayosi clinicalandepidemiologicalaspectsofstreptococcuspyogenespharyngitisandcarriageinafrica
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Clinical and epidemiological aspects of streptococcus pyogenes pharyngitis and carriage in Africa

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