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State transitions across the Strep A disease spectrum: scoping review and evidence gaps
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- Authors
- Issue Date
- 2024-01-19
- Publisher
- BMC
- Citation
- BMC Infectious Diseases, Vol.24 no.108
- Keywords
- Group A Streptococcus ; Strep A disease ; Pharyngitis ; Skin infection ; Acute rheumatic fever ; Acute poststreptococcal glomerulonephritis ; Rheumatic heart disease ; Invasive disease ; State transition ; Scoping review ; Invasive disease
- Abstract
- The spectrum of diseases caused by Streptococcus pyogenes (Strep A) ranges from superficial to serious life-threatening invasive infections. We conducted a scoping review of published articles between 1980 and 2021 to synthesize evidence of state transitions across the Strep A disease spectrum. We identified 175 articles reporting 262 distinct observations of Strep A disease state transitions. Among the included articles, the transition from an invasive or toxin-mediated disease state to another disease state (i.e., to recurrent ARF, RHD or death) was described 115 times (43.9% of all included transition pairs) while the transition to and from locally invasive category was the lowest (n = 7; 0.02%). Transitions from well to any other state was most frequently reported (49%) whereas a relatively higher number of studies (n = 71) reported transition from invasive disease to death. Transitions from any disease state to locally invasive, Strep A pharyngitis to invasive disease, and chronic kidney disease to death were lacking. Transitions related to severe invasive diseases were more frequently reported than superficial ones. Most evidence originated from high-income countries and there is a critical need for new studies in low- and middle-income countries to infer the state transitions across the Strep A disease spectrum in these high-burden settings.
- ISSN
- 1471-2334
- Language
- English
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