Abstract
BackgroundGroup A Streptococcus (Strep A) is an important cause of mortality and morbidity globally. This bacterium is responsible for a range of different infections and post-infectious sequelae. Summarising the current knowledge of Strep A transmission to humans will address gaps in the evidence and inform prevention and control strategies. The objective of this study is to evaluate the modes of transmission and attack rates of group A streptococcal infection in human populations.MethodsThis systematic review protocol was prepared according to the Preferred Reporting Items for Systematic reviews and Meta-analysis Protocols (PRISMA-P) 2015 Statement. Using a comprehensive search strategy to identify any transmission studies that have been published in English since 1980, full-text articles will be identified and considered for inclusion against predefined criteria. We will include all studies reporting on Strep A transmission, who have identified a mode of transmission, and who reported attack rates. Risk of bias will be appraised using an appropriate tool. Our results will be described narratively and where feasible and appropriate, a meta-analysis utilizing the random-effects model will be used to aggregate the incidence proportions (attack rates) for each mode of transmission. In addition, we will also evaluate the emm genotype variants of the M protein causing Strep A infection and the association with transmission routes and attack rates, if any, by setting, socioeconomic background and geographical regions.DiscussionWe anticipate that this review will contribute to elucidating Strep A modes of transmission which in turn, will serve to inform evidence-based strategies including environmental health activities to reduce the transmission of Strep A in populations at risk of severe disease.Trial registrationSystematic review registration: PROSPERO (CRD42019138472).
Highlights
Group A Streptococcus (Strep A) is an important cause of mortality and morbidity globally
The objectives of this review are to (1) synthesize the evidence of modes of transmission for Strep A, (2) calculate and compare attack rates against mode of transmission, and (3) correlate emm types of Strep A isolated from clinical swabs and mode of transmission, where possible
This systematic review seeks to provide robust contemporary evidence for the modes involved in Strep A transmission
Summary
Group A Streptococcus (Strep A) is an important cause of mortality and morbidity globally. This bacterium is responsible for a range of different infections and post-infectious sequelae. The objective of this study is to evaluate the modes of transmission and attack rates of group A streptococcal infection in human populations. Streptococcus pyogenes, known as Group A Streptococcus (Strep A), is responsible for a wide range of diseases and is in the top 10 pathogens globally causing morbidity and mortality, in disadvantaged settings around the world [1]. Epidemiological studies have reported an association of emm type with different disease manifestations, populations and climate [1, 7,8,9,10,11]
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