Home > Review Articles > Ethnic disparities > Preceding group A streptococcus skin and throat infections are individually associated with acute rheumatic fever

Preceding group A streptococcus skin and throat infections are individually associated with acute rheumatic fever

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From Māori Health Review Issue 95
Authors:
  • Oliver J et al.
Summary:

A large study of throat and skin swab data from the Auckland region has demonstrated that group A streptococcus (GAS) skin infections are strongly associated with subsequent acute rheumatic fever. A total of 1,866,981 throat and skin swabs collected between 2010 and 2017 were analysed, as well as antibiotic dispensing data for the same period and hospitalisations for acute rheumatic fever between 2010 and 2018. Māori and Pacific individuals had the highest risk of acute rheumatic fever in the 8- to 90-day period following a GAS-positive throat (relative risk 4.8; 95% CI 3.6-6.4) or skin (relative risk 5.1; 95% CI 1.8-15.0) swab. Antibiotic dispensing was not associated with a reduction in the risk of acute rheumatic fever following either a GAS-positive throat or skin swab.

Comment:
Although some have hypothesised that GAS skin infections are associated with subsequent acute rheumatic fever, this study provides clear evidence for it, including its risk compared with traditional throat infections, and the increased risk for Māori and Pacific peoples.
Reference: BMJ Glob Health. 2021;6(12):e007038.
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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