ArticleBMJ global health2021
Preceding group A streptococcus skin and throat infections are individually associated with acute rheumatic fever: evidence from New Zealand.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Long-term antibiotic prophylaxis for prevention of rheumatic fever recurrence and progression to rheumatic heart disease.The Cochrane database of systematic reviews · 2024Pooled it
- Baicalin-Chlorogenic Acid Self-Assembled Nanoparticles: A Carrier-Free Nano-Formulation for the Treatment of Acute Pharyngitis.Biomedicines · 2026Article
- Group C/G Streptococcal Pharyngitis and Acute Rheumatic Fever in Auckland, New Zealand, 2010-2016.Journal of paediatrics and child health · 2026Article
- Person, Provider, Practice and Policy-P4: A framework for two-way learning and aboriginal community-led health promotion and evaluation.Dialogues in health · 2026Article
- Rheumatic heart disease in children and adolescents, part 1: epidemiology, pathogenesis and diagnosis.BMJ paediatrics open · 2026Review
- Acute rheumatic fever and rheumatic heart disease.Nature reviews. Disease primers · 2026Review
- Global disparities in the detection and management of rheumatic heart disease in pregnancy across endemic settings.Frontiers in surgery · 2026Review
- Household Molecular Epidemiology of Streptococcus pyogenes Carriage and Infection in The Gambia.The Journal of infectious diseases · 2025Observational
- New evidence supports a greater focus on streptococcal skin infections to prevent rheumatic fever.The Medical journal of Australia · 2025Article
- Assessing the evidence for antibiotic management of laboratory-confirmedIJID regions · 2025Review
- Epidemiological and Clinical Manifestations of Acute Rheumatic Fever in Far North Queensland, Australia.Pathogens (Basel, Switzerland) · 2025Article
- Molecular Methods Enhance the Detection of Pyoderma-Related Streptococcus pyogenes and emm-Type Distribution in Children.The Journal of infectious diseases · 2025Article
- The roles of immuno-modulator treatment and echocardiographic screening in rheumatic fever and rheumatic heart disease control: research from Aotearoa, New Zealand.Journal of the Royal Society of New Zealand · 2025Review
- A mini review of the pathogenesis of acute rheumatic fever and rheumatic heart disease.Frontiers in cellular and infection microbiology · 2025Review
- Longitudinal surveillance of group A streptococcal pharyngitis and impetigo in remote Western Australian school children informs acute rheumatic fever prevention.PLOS global public health · 2025Article
- Training of Field-Workers for Rapid Assessment of Scabies Prevalence: A Diagnostic Accuracy Study in Mozambique.The American journal of tropical medicine and hygiene · 2024Article
- Ivermectin-Based Mass Drug Administration for Scabies in Northern India: A Single-Arm Community Intervention Trial.Open forum infectious diseases · 2024Article
- Article
- [Research progress on the mechanism of -lactam resistance in group AZhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Review
- Sudan's rheumatic fever and rheumatic heart disease guidelines: a simplified approach in an endemic country.Frontiers in cardiovascular medicine · 2024Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute rheumatic fever (ARF) is usually considered a consequence of group A streptococcus (GAS) pharyngitis, with GAS skin infections not considered a major trigger. The aim was to quantify the risk of ARF following a GAS-positive skin or throat swab.
methodsThis retrospective analysis used pre-existing administrative data. Throat and skin swab data (1 866 981 swabs) from the Auckland region, New Zealand and antibiotic dispensing data were used (2010-2017). Incident ARF cases were identified using hospitalisation data (2010-2018). The risk ratio (RR) of ARF following swab collection was estimated across selected features and timeframes. Antibiotic dispensing data were linked to investigate whether this altered ARF risk following GAS detection.
resultsARF risk increased following GAS detection in a throat or skin swab. Māori and Pacific Peoples had the highest ARF risk 8-90 days following a GAS-positive throat or skin swab, compared with a GAS-negative swab. During this period, the RR for Māori and Pacific Peoples following a GAS-positive throat swab was 4.8 (95% CI 3.6 to 6.4) and following a GAS-positive skin swab, the RR was 5.1 (95% CI 1.8 to 15.0). Antibiotic dispensing was not associated with a reduction in ARF risk following GAS detection in a throat swab (antibiotics not dispensed (RR: 4.1, 95% CI 2.7 to 6.2), antibiotics dispensed (RR: 4.3, 95% CI 2.5 to 7.4) or in a skin swab (antibiotics not dispensed (RR: 3.5, 95% CI 0.9 to 13.9), antibiotics dispensed (RR: 2.0, 95% CI 0.3 to 12.1).
conclusionsA GAS-positive throat or skin swab is strongly associated with subsequent ARF, particularly for Māori and Pacific Peoples. This study provides the first population-level evidence that GAS skin infection can trigger ARF.
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