Modes of transmission and attack rates of group A Streptococcal infection: a protocol for a systematic review and meta-analysis

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Abstract

Background

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. 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.

Methods

This 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.

Discussion

We 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 registration

Systematic review registration: PROSPERO ( CRD42019138472).

Supplementary Information

The online version contains supplementary material available at 10.1186/s13643-021-01641-5.

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Most cited references 53

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Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

David Moher, Larissa Shamseer, Mike Clarke … (2017)

Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.

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Skin microbiota: a source of disease or defence?

A L Cogen, V Nizet, R L Gallo (2008)

Microbes found on the skin are usually regarded as pathogens, potential pathogens or innocuous symbiotic organisms. Advances in microbiology and immunology are revising our understanding of the molecular mechanisms of microbial virulence and the specific events involved in the host-microbe interaction. Current data contradict some historical classifications of cutaneous microbiota and suggest that these organisms may protect the host, defining them not as simple symbiotic microbes but rather as mutualistic. This review will summarize current information on bacterial skin flora including Staphylococcus, Corynebacterium, Propionibacterium, Streptococcus and Pseudomonas. Specifically, the review will discuss our current understanding of the cutaneous microbiota as well as shifting paradigms in the interpretation of the roles microbes play in skin health and disease.

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Global emm type distribution of group A streptococci: systematic review and implications for vaccine development.

Andrew Steer, Irwin Law, Laisiana Matatolu … (2009)

emm sequence typing is the most widely used method for defining group A streptococcal (GAS) strains, and has been applied to isolates in all regions of the world. We did a systematic review of the global distribution of GAS emm types. 102 articles and reports were included (38 081 isolates). Epidemiological data from high-income countries were predominant, with sparse data from low-income countries. The epidemiology of GAS disease in Africa and the Pacific region seems to be different from that in other regions, particularly high-income countries. In Africa and the Pacific, there were no dominant emm types, a higher diversity of emm types, and many of the common emm types in other parts of the world were less common (including emm 1, 4, 6, and 12). Our data have implications for the development of GAS vaccines. On the basis of the available data, the current formulation of the experimental multivalent emm vaccine would provide good coverage in high-income countries, particularly USA, Canada, and Europe, but poor coverage in Africa and the Pacific, and only average coverage in Asia and the Middle East.

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Author and article information

Contributors

Dylan D. Barth:

ORCID: http://orcid.org/0000-0001-5687-7942

Dylan.Barth@telethonkids.org.au

Jessica Daw: Jessica.Daw@telethonkids.org.au

Ruomei Xu: xu_ruomei@163.com

Stephanie Enkel: Stephanie.Enkel@telethonkids.org.au

Janessa Pickering: Janessa.Pickering@telethonkids.org.au

Tracy McRae: Tracy.McRae@telethonkids.org.au

Mark E. Engel: Mark.Engel@uct.ac.za

Jonathan Carapetis: jonathan.carapetis@telethonkids.org.au

Rosemary Wyber: Rosemary.Wyber@telethonkids.org.au

Asha C. Bowen: Asha.Bowen@telethonkids.org.au

Journal

Journal ID (nlm-ta): Syst Rev

Journal ID (iso-abbrev): Syst Rev

Title: Systematic Reviews

Publisher: BioMed Central (London )

ISSN (Electronic): 2046-4053

Publication date (Electronic): 31 March 2021

Publication date PMC-release: 31 March 2021

Publication date Collection: 2021

Volume: 10

Electronic Location Identifier: 90

Affiliations

[1 ]GRID grid.414659.b, ISNI 0000 0000 8828 1230, Wesfarmers Centre for Vaccines and Infectious Diseases, , Telethon Kids Institute, ; Perth, Western Australia Australia

[2 ]GRID grid.1012.2, ISNI 0000 0004 1936 7910, The University of Western Australia, ; Perth, Western Australia Australia

[3 ]GRID grid.7836.a, ISNI 0000 0004 1937 1151, AFROStrep Registry, Department of Medicine, , The University of Cape Town, ; Cape Town, South Africa

[4 ]GRID grid.410667.2, ISNI 0000 0004 0625 8600, Department of Infectious Diseases, , Perth Children’s Hospital, ; Perth, Western Australia

[5 ]GRID grid.415508.d, ISNI 0000 0001 1964 6010, The George Institute for Global Health, ; Sydney, New South Wales Australia

Author information

Dylan D. Barth http://orcid.org/0000-0001-5687-7942

Article

Publisher ID: 1641

DOI: 10.1186/s13643-021-01641-5

PMC ID: 8011413

PubMed ID: 33789732

SO-VID: 488715af-efcd-4e69-8664-a0418f32604c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 10 September 2020

Date accepted : 19 March 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;

Award ID: GTN1080401

Award Recipient : Jonathan Carapetis

Custom metadata

ScienceOpen disciplines: Public health

Keywords: group a streptococcus,transmission,systematic review,environmental health,public health

Data availability:

ScienceOpen disciplines: Public health

Keywords: group a streptococcus, transmission, systematic review, environmental health, public health

Modes of transmission and attack rates of group A Streptococcal infection: a protocol for a systematic review and meta-analysis

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Abstract

Background

Methods

Discussion

Trial registration

Supplementary Information

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Climate Change and Human Health

Most cited references 53

Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

Skin microbiota: a source of disease or defence?

Global emm type distribution of group A streptococci: systematic review and implications for vaccine development.

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Contributors

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