Socio-environmental and clinical features of invasive group A streptococcal disease in the Northern Territory of Australia

Authors

  • Johanna M Birrell Northern Territory Centre for Disease Control, NT Health, Darwin, NT
  • Bart J Currie Menzies School of Health Research, Charles Darwin University, Darwin, NT; Northern Territory Medical Program, Royal Darwin Hospital, Darwin, NT
  • Asanga Abeyaratne Menzies School of Health Research, Charles Darwin University, Darwin, NT; Northern Territory Medical Program, Royal Darwin Hospital, Darwin, NT
  • Sandawana William Majoni Menzies School of Health Research, Charles Darwin University, Darwin, NT; Northern Territory Medical Program, Royal Darwin Hospital, Darwin, NT
  • Rowena Boyd Northern Territory Centre for Disease Control, NT Health, Darwin, NT

DOI:

https://doi.org/10.33321/cdi.2023.47.39

Keywords:

streptococcus; epidemiology; public health; rural health; dialysis

Abstract

Objective

To describe the socio-environmental profile and clinical features of invasive group A streptococcal (iGAS) infections in the Northern Territory (NT) of Australia over 10 years.

Methods

Cases of iGAS disease diagnosed between 1 May 2011 and 30 April 2021 were retrospectively identified from the NT Notifiable Diseases System and electronic health records accessed. Remoteness of residence, socio-economic index, seasonality and clinical characteristics were recorded.

Results

There were 692 cases of iGAS disease identified in the NT during the period 1 May 2011 – 30 April 2021. The age-standardised incidence of iGAS disease was significantly higher in people living in very remote (57.1 cases per 100,000 population, 95% confidence interval [95% CI]: 48.6–65.5) and remote areas (40.9 cases per 100,000 population, 95% CI: 34.7–47.2) than in outer regional areas of the NT (15.7 cases per 100,000 population, 95% CI: 13.4–17.9). People with socio-economic disadvantage were also disproportionately affected, with an incidence of 52.6 cases per 100,000 population (95% CI: 46.2–58.9) in decile 1–3 populations, compared to 8.9 cases per 100,000 population (95% CI: 6.9–10.9) for decile 7–10.

For cases with recorded severity data, 135 of 378 (36%) met locally-defined criteria for severe iGAS disease. Recurrent iGAS disease was commonly observed in the dialysis cohort, affecting 17 of the 106 patients during the study period (16% recurrence rate) and causing two deaths. Five molecularly-confirmed clusters of iGAS disease were identified from the study period.

Conclusions

iGAS disease is unevenly affecting people in the NT. Those living in areas of socio-economic disadvantage, those in remote and very remote communities, and those receiving dialysis were most affected. It is important that primordial, primary and secondary prevention measures be directed towards supporting these disadvantaged population groups.

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Published

27/07/23

How to Cite

Birrell, Johanna M, Bart J Currie, Asanga Abeyaratne, Sandawana William Majoni, and Rowena Boyd. 2023. “Socio-Environmental and Clinical Features of Invasive Group A Streptococcal Disease in the Northern Territory of Australia ”. Communicable Diseases Intelligence 47 (July). https://doi.org/10.33321/cdi.2023.47.39.

Issue

Vol. 47 (2023)

Section

Original article

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