A pilot study to develop assessment tools for Group A Streptococcus surveillance studies
Introduction Group 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 t...
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PeerJ Inc.
2023-03-01
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| Online Access: | https://peerj.com/articles/14945.pdf |
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| author | Janessa Pickering Claudia Sampson Marianne Mullane Meru Sheel Dylan D. Barth Mary Lane Roz Walker David Atkinson Jonathan R. Carapetis Asha C. Bowen |
| author_facet | Janessa Pickering Claudia Sampson Marianne Mullane Meru Sheel Dylan D. Barth Mary Lane Roz Walker David Atkinson Jonathan R. Carapetis Asha C. Bowen |
| author_sort | Janessa Pickering |
| collection | DOAJ |
| description | Introduction Group 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. Methods Yarning 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. Results Ten 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. Conclusion Yarning 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. |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-09T06:22:08Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-c2d5f834a601425e8680b0d7defb185c2023-12-03T11:38:16ZengPeerJ Inc.PeerJ2167-83592023-03-0111e1494510.7717/peerj.14945A pilot study to develop assessment tools for Group A Streptococcus surveillance studiesJanessa Pickering0Claudia Sampson1Marianne Mullane2Meru Sheel3Dylan D. Barth4Mary Lane5Roz Walker6David Atkinson7Jonathan R. Carapetis8Asha C. Bowen9Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia., Perth, AustraliaSchool of Medicine, University of Western Australia, Crawley, Perth, AustraliaWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia., Perth, AustraliaSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, AustraliaWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia., Perth, AustraliaBroome Regional Aboriginal Medical Service, Broome, AustraliaSchool of Population and Global Health, University of Western Australia, Perth, AustraliaSchool of Medicine, University of Western Australia, Crawley, Perth, AustraliaWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia., Perth, AustraliaWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia., Perth, AustraliaIntroduction Group 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. Methods Yarning 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. Results Ten 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. Conclusion Yarning 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.https://peerj.com/articles/14945.pdfRheumatic fever (RF)Group A Streptococcus (GAS)GAS pharyngitisGAS impetigoGAS skin sores |
| spellingShingle | Janessa Pickering Claudia Sampson Marianne Mullane Meru Sheel Dylan D. Barth Mary Lane Roz Walker David Atkinson Jonathan R. Carapetis Asha C. Bowen A pilot study to develop assessment tools for Group A Streptococcus surveillance studies PeerJ Rheumatic fever (RF) Group A Streptococcus (GAS) GAS pharyngitis GAS impetigo GAS skin sores |
| title | A pilot study to develop assessment tools for Group A Streptococcus surveillance studies |
| title_full | A pilot study to develop assessment tools for Group A Streptococcus surveillance studies |
| title_fullStr | A pilot study to develop assessment tools for Group A Streptococcus surveillance studies |
| title_full_unstemmed | A pilot study to develop assessment tools for Group A Streptococcus surveillance studies |
| title_short | A pilot study to develop assessment tools for Group A Streptococcus surveillance studies |
| title_sort | pilot study to develop assessment tools for group a streptococcus surveillance studies |
| topic | Rheumatic fever (RF) Group A Streptococcus (GAS) GAS pharyngitis GAS impetigo GAS skin sores |
| url | https://peerj.com/articles/14945.pdf |
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