Abstract
.Acute post-streptococcal glomerulonephritis (APSGN) is an inflammatory kidney disease following infection with nephritogenic strains of Group A Streptococcus. In 1991, APSGN became notifiable in the Northern Territory (NT) of Australia with cases recorded on the NT Notifiable Disease Database (NTNDS). The case definition of a confirmed case requires laboratory definitive evidence or laboratory suggestive evidence in conjunction with a clinically compatible illness. Probable cases require clinical evidence only. Acute post-streptococcal glomerulonephritis notifications from 2009 to 2016 were extracted from the NTNDS. Of the 322 cases, 261 were confirmed and 61 probable. The majority, 304 (94%), were Aboriginal and the median age was 8 years (range: 0–62 years). Incidence for confirmed cases was 13.8/100,000 person-years, with inclusion of probable cases increasing incidence to 17.0/100,000 person-years. Highest incidence of confirmed cases was in Aboriginal children less than 15 years of age at 124.0 cases/100,000 person-years. The rate ratio of confirmed cases in Aboriginal to non-Aboriginal Australians was 18.9 (95% confidence interval: 11.4–33.6). Recent trends show a consistently high number of notifications annually with less frequent outbreaks. The Aboriginal population of the NT continues to have high rates of APSGN with recent trends showing higher rates than previously reported. Sustained preventative efforts and continued surveillance strategies are needed.
Highlights
Aboriginal Australians suffer one of the highest rates of chronic kidney disease (CKD) in the world.[1]
Acute poststreptococcal glomerulonephritis (APSGN) is an inflammatory kidney disease caused by prior infection with nephritogenic strains of Group A Streptococcus (GAS)
Median age was 8 years, with an interquartile range of 1–44 years including one infant less than 12 months diagnosed at 11 months
Summary
Aboriginal Australians suffer one of the highest rates of chronic kidney disease (CKD) in the world.[1] Acute poststreptococcal glomerulonephritis (APSGN) is an inflammatory kidney disease caused by prior infection with nephritogenic strains of Group A Streptococcus (GAS). Previous work by Hoy et al.[2] reported APSGN as a major risk factor for the development of CKD in the Australian Aboriginal population living in remote communities. Recognition of the heavy burden of disease in the Northern Territory (NT) led to establishment of case definitions, mandatory clinician notification of disease, and establishment of an APSGN database in 1991. The confirmed case requires either laboratory definitive evidence (renal biopsy suggestive of APSGN) or the presence of both laboratory suggestive evidence and clinical evidence (Table 1). A contact is defined as those staying in the house in the 2 weeks preceding the onset of the illness
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