State transitions across the Strep A disease spectrum: scoping review and evidence gaps

State transitions across the Strep A disease spectrum: scoping review and evidence gaps

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Abstract The spectrum of diseases caused by Streptococcus pyogenes (Strep A) ranges from superficial to serious life-threatening invasive infections.We conducted a scoping review of published articles between 1980 and 2021 to synthesize evidence of state transitions across the Strep A disease spectrum.We identified 175 articles reporting 262 distinct observations of Strep A disease state transitions.

Among the included articles, the transition from an invasive or toxin-mediated disease state to another disease state (i.e., to recurrent ARF, RHD or death) was described 115 times (43.

9% of all 7gm pravana included transition pairs) while the transition to and from locally invasive category was the lowest (n = 7; 0.02%).Transitions from well to any other state was most frequently reported (49%) whereas a relatively higher number of studies (n = 71) reported transition from invasive disease to death.

Transitions from any disease state cocktail tree for sale to locally invasive, Strep A pharyngitis to invasive disease, and chronic kidney disease to death were lacking.Transitions related to severe invasive diseases were more frequently reported than superficial ones.Most evidence originated from high-income countries and there is a critical need for new studies in low- and middle-income countries to infer the state transitions across the Strep A disease spectrum in these high-burden settings.