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Acute post-streptococcal glomerulonephritis in Central Australia

James Dowler1, Angela Wilson2

  • 1Alice Springs Hospital, Flinders University College of Medicine and Public Health, Alice Springs, Northern Territory, Australia.

The Australian Journal of Rural Health
|October 30, 2019
PubMed

Insights

Acute post-streptococcal glomerulonephritis (APSGN) is highest in Aboriginal children in Central Australia. Improved housing and reduced overcrowding are urgently needed to combat this Group A Streptococcus related disease.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Acute post-streptococcal glomerulonephritis (APSGN) is a post-infectious kidney disease.
  • Group A Streptococcus (GAS) infections are a known trigger for APSGN.
  • Limited data exists on APSGN incidence in remote Australian populations.

Purpose of the Study:

  • To determine the incidence, clinical presentation, and progress of APSGN in Central Australia.
  • To identify associated biochemical abnormalities and co-occurring conditions.
  • To inform public health strategies for disease prevention.

Main Methods:

  • Retrospective observational analysis of paediatric inpatient admissions.
  • Inclusion criteria: patients under 14 years admitted to Alice Springs Hospital (2010-2014) meeting APSGN diagnostic criteria.
  • Data collected on incidence, clinical features, biochemical markers, and co-infections.

Main Results:

  • Identified 69 cases of APSGN (or probable APSGN) out of 174 reviewed.
  • Calculated incidence of APSGN admission higher than previously reported, and the highest globally in children.
  • Frequently documented skin infections, co-occurring infections (scabies, UTI, pneumonia), and acute kidney injury in 53 patients.

Conclusions:

  • Aboriginal children in Central Australia exhibit the world's highest incidence of APSGN.
  • Urgent improvements in housing and reduction of overcrowding are critical to decrease GAS-related disease burden.
  • Without improved living conditions, significant reduction in APSGN morbidity is unlikely.
Abstract

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