Epidemiology of streptococcal infection with reference to Rheumatic fever

  • Dr. Lalit Une Professor in Pediatrics, L N Medical College, Bhopal, India
  • Dr. Umesh Patel Associate Professor in Pediatrics, L N Medical College, Bhopal, India
  • Dr. R V Borgaonkar Professor in Pediatrics, Government Medical College, Aurangabad, India
  • Dr. Narmada P Patel Assistant Professor in Medicine, L N Medical College, Bhopal, India
Keywords: ASO, GAS, Sore throat, Streptococcal sore throat

Abstract

Introduction: Group A hemolytic streptococcal infections have a worldwide distribution among children and it poses an important health problem globally. Group A streptococcal (GAS) serology is used for the diagnosis of post-streptococcal diseases, such as acute rheumatic fever, post-streptococcal Glomerulonephritis and occasionally for the diagnosis of streptococcal pharyngitis. Upper normal limits for streptococcal serology should be determined for individual populations because of differences in the epidemiology of GAS between populations.

Material & Methods: Study materials were divided in 3 groups. Group-A (normal children population), group- B (children clinically diagnosed as acute bacterial sore throat) and group-C (children clinically diagnosed rheumatic fever). ASO titer & throat culture were assessed in all three groups.

Result: When cut off range of ASO titer is >200 IU/ml, it is positive in 20%, 38% and 54.4% in Group A, B and C respectively. But When titer range increased to >400 IU/ml, it was positive in 40 %, 36.84% and 44.44% cases from Group A, B & C respectively.

Conclusion: Cut off point of 200 IU/ml has limitations in our setup. Use of western cut off 200 IU/ml needs to be revised in relation to local epidemiology to get less false positive results.

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References

1. Martin, D. R., L. M. Voss, S. J. Walker, and D. Lennon. Acute rheumatic fever in Auckland, New Zealand: spectrum of associated group A streptococci different from expected. Pediatr Infect Dis J. 1994; 13 (4): 264-269. [PubMed]

2. Kaplan, E. L., P. Ferrieri, and L. W. Wannamaker.Comparison of the antibody response to streptococcal cellular and extracellular antigens in acute pharyngitis. J Pediatr. 1974; 84(1):21-28. [PubMed]

3. Shet, A., and E. L. Kaplan. 2002. Clinical use and interpretation of group A streptococcal antibody tests: a practical approach for the pediatrician or primary care physician. Pediatr Infect Dis J.2002; 21(5):420-426.[PubMed]

4. Wannamaker, L. W., and E. M. Ayoub. 1960. Antibody titers in acute rheumatic fever. Circulation. 1960; 21(Apr):598-614. [PubMed]

5. Machado CS, Ortiz K, Martins Ade L, Martins RS, Machado NC. Antistreptolysin O titer profile in acute rheumatic fever diagnosis. J Pediatr (Rio J). 2001; 77(2):105-111. [PubMed]

6. Klein, G. C., C. N. Baker, and W. L. Jones. “Upper limits of normal” antistreptolysin O and antideoxyribonuclease B titers. Appl Microbiol. 1971; 21(6): 999-1001. [PubMed]

7. Giovanna Zaninetta M, Moccia F, Paolo Mazzarello G, Mansuino P, Morra L. Evaluation of antibody specificity of the monoclonal component in a case of Waldenström's macroglobulinemia. 1992;7(1):42-45. [PubMed]

8. Sethi S, Kaushik K, Mohandas K, Sengupta C, Singh S, Sharma M. Anti-streptolysin O titers in normal healthy children of 5-15 years. Indian Pediatr. 2003;40(11):1068-1071. [PubMed]

9. Kaplan, E. L., C. D. Rothermel, and D. R. Johnson. 1998. Antistreptolysin O and anti-deoxyribonuclease B titers: normal values for children ages 2 to 12 in the United States. Pediatrics. 1998; 101(1):86-88. [PubMed]

10. Nimmo, G. R., R. D. Tinniswood, N. Nuttall, G. M. Baker, and B. McDonald. Group A streptococcal infection in an aboriginal community. Med. J. 1992; 157(8):521-522. [PubMed]

11. Van Buynder, P. G., J. A. Gaggin, D. Martin, D. Pugsley, and J. D. Mathews. Streptococcal infection and renal disease markers in Australian aboriginal children. Med. J. Aust.1992; 156(8):537-540. [PubMed]

12. Blyth, C. C., and P. W. Robertson. Anti-streptococcal antibodies in the diagnosis of acute and poststreptococcal disease: streptokinase versus streptolysin O and deoxyribonuclease B. Pathology. 2006; 38(2):152-156.

13. Danchin, M. H., J. B. Carlin, W. Devenish, T. M. Nolan, and J. R. Carapetis. New normal ranges of antistreptolysin O and anti-deoxyribonuclease B titres for Australian children. J. Paediatr Child Health. 2005; 41(11):583-586. [PubMed]

14. Kaplan, E. L., C. D. Rothermel, and D. R. Johnson. Antistreptolysin O and anti-deoxyribonuclease B titers: normal values for children ages 2 to 12 in the United States. Pediatrics. 1998; 101 (1 pt1): 86-88. [PubMed]

15. Karmarkar, M. G., V. Venugopal, L. Joshi, and R. Kamboj. Evaluation & revaluation of upper limits of normal values of anti-streptolysin O and ant-deoxyribonuclease B in Mumbai. Indian J. Med. Res. 2004:119(Suppl.) 26-28.[PubMed]

16. Royston, P. Constructing time-specific reference ranges. Stat. Med. 1991; 10(5):675-690. [PubMed]

17. Bhave SY, Kinikar A, Sane S, Agarwal M, Amdekar YK. Epidemiology of streptococcal infection with reference to rheumatic fever. Indian Pediatr. 1991; 28(12):1503-1508. [PubMed]

18. W. R. O. Goslings, H. A. Valkenburg, A. W. Bots and J. C. Lorrier. Attack Rates of Streptococcal Pharyngitis, Rheumatic Fever and Glomerulonephritis in the General Population - A Controlled Pilot Study of Streptococcal Pharyngitis in One Village. N Engl J Med. 1963; 268(13):687-694.

19. Alan C. Siegel, Eloise E. Johnson, and Gene H. Stollerman. Controlled Studies of Streptococcal Pharyngitis in a Pediatric Population - Factors Related to the Attack Rate of Rheumatic Fever. N Engl J Med. 1961; 265(12):559-566.

20. Koshi G, Benjamin V.Surveillance of streptococcal infections in children in a south Indian community-a pilot survey. Indian J Med Res.1977; 66(3):379-88. [PubMed]

21. Koshi G, Jadhav M, Myers RM. Streptococcal pharyngitis in children. Indian J Med Res.1970; 58(2):161-171.

22. Stollerman GH, Lewis AJ, Schultzi I, Taranta A. Relationship of immune response to group A streptococci to the course of acute, chronic and recurrent rheumatic fever. Am J Med.1956; 20(2):163-169.
CITATION
DOI: 10.17511/ijmrr.2013.i03.05
Published: 2013-08-31
How to Cite
1.
Une L, Patel U, Borgaonkar RV, P Patel N. Epidemiology of streptococcal infection with reference to Rheumatic fever. Int J Med Res Rev [Internet]. 2013Aug.31 [cited 2024Apr.25];1(3):106-13. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/16
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Original Article

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