Estimated burden of group a streptococcal pharyngitis among children in Beijing, China

doi:10.1186/s12879-016-1775-9

. 2016 Aug 26;16(1):452.

doi: 10.1186/s12879-016-1775-9.

Estimated burden of group a streptococcal pharyngitis among children in Beijing, China

Shuangsheng Wu^{1

2}, Xiaomin Peng^{1

2}, Zuyao Yang³, Chunna Ma^{1

2}, Daitao Zhang^{1

2}, Quanyi Wang^{1

2}, Peng Yang^{4

5}

Affiliations

¹ Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China.
² School of Public Health, Captial Medical University, Beijing, China.
³ Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China.
⁴ Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China. yangpengcdc@163.com.
⁵ School of Public Health, Captial Medical University, Beijing, China. yangpengcdc@163.com.

PMID: 27566251
PMCID: PMC5002216
DOI: 10.1186/s12879-016-1775-9

Estimated burden of group a streptococcal pharyngitis among children in Beijing, China

Shuangsheng Wu et al. BMC Infect Dis. 2016.

. 2016 Aug 26;16(1):452.

doi: 10.1186/s12879-016-1775-9.

Authors

Shuangsheng Wu^{1

2}, Xiaomin Peng^{1

2}, Zuyao Yang³, Chunna Ma^{1

2}, Daitao Zhang^{1

2}, Quanyi Wang^{1

2}, Peng Yang^{4

5}

Affiliations

¹ Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China.
² School of Public Health, Captial Medical University, Beijing, China.
³ Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China.
⁴ Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China. yangpengcdc@163.com.
⁵ School of Public Health, Captial Medical University, Beijing, China. yangpengcdc@163.com.

PMID: 27566251
PMCID: PMC5002216
DOI: 10.1186/s12879-016-1775-9

Abstract

Background: Burden of Group A streptococcus (GAS) pharyngitis is scarce in developing countries, still unknown in China. The objective of this study was to determine the incidence of clinical cases of pharyngitis and GAS culture-positive pharyngitis, and their outpatient visits among children aged 0-14 years in Beijing, the capital of China.

Methods: Multiplier model was used to estimate the numbers of pharyngitis cases, based on reported numbers of clinical cases and GAS culture-positive rates from GAS surveillances in Beijing, consultation rate, population coverage of GAS surveillances, sampling success rate, and test sensitivity of GAS culture from previous studies, surveys and surveillances.

Results: An average of 29804.6 (95 % CI: 28333.2-31276.0) clinical cases of pharyngitis per 100,000 person-years occurred among children aged 0-14 years, resulting in correspondingly 19519.0 (95 % CI: 18516.7-20521.2) outpatient visits per 100,000 person-years from 2012 to 2014 in Beijing. On average, there were 2685.1 (95 % CI: 2039.6-3330.6) GAS culture-positive cases of pharyngitis and 1652.7 (95 % CI: 1256.5-2049.0) outpatient visits per 100,000 person-years during the same period. The estimated burden of GAS pharyngitis was significantly higher than that of scarlet fever. Children aged 5-14 years had a higher burden of GAS pharyngitis than those aged 0-4 years.

Conclusions: The present data suggests that GAS pharyngitis is very common in children in China. Further studies and surveillances are needed to monitor trends and the effectiveness of control measures.

Keywords: Burden; China; Group A streptococcus; Pharyngitis.

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Figures

**Fig. 1**
Model parameters for estimating the burden of GAS pharyngitis in Beijing, 2012–2014. Note: A, Total no. cases of GAS culture-positive pharyngitis in Beijing; B, Cases refer to hospitals in Beijing = A* Consultation rate; C, Cases refer to sentinel hospitals of GAS surveillances in Beijing = B*Population coverage of GAS surveillances in Beijing; D, Cases for which specimens were successfully collected = C*Sampling success rate; E, Predicted positive specimens that were correctly identified by laboratory tests = D*Test sensitivity

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References

1. Wessels MR. Clinical practice. Streptococcal pharyngitis. N Engl J Med. 2011;364(7):648–655. doi: 10.1056/NEJMcp1009126. - DOI - PubMed
1. Bisno AL. Acute pharyngitis. N Engl J Med. 2001;344(3):205–211. doi: 10.1056/NEJM200101183440308. - DOI - PubMed
1. Pfoh E, Wessels MR, Goldmann D, Lee GM. Burden and economic cost of group A streptococcal pharyngitis. Pediatrics. 2008;121(2):229–234. doi: 10.1542/peds.2007-0484. - DOI - PubMed
1. World Health Organization. The Current Evidence for the Burden of Group A Streptococcal Diseases. Discussion papers on Child Health. Department of Child and Adolescent Health and Development, WHO. http://whqlibdoc.who.int/hq/ 2005/WHO_FCH_CAH_05.07.pdf. Accessed 25 Nov 2015.
1. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5:685–694. doi: 10.1016/S1473-3099(05)70267-X. - DOI - PubMed

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[1] Wessels MR. Clinical practice. Streptococcal pharyngitis. N Engl J Med. 2011;364(7):648–655. doi: 10.1056/NEJMcp1009126. - DOI - PubMed

[2] Wessels MR. Clinical practice. Streptococcal pharyngitis. N Engl J Med. 2011;364(7):648–655. doi: 10.1056/NEJMcp1009126. - DOI - PubMed

[3] Bisno AL. Acute pharyngitis. N Engl J Med. 2001;344(3):205–211. doi: 10.1056/NEJM200101183440308. - DOI - PubMed

[4] Bisno AL. Acute pharyngitis. N Engl J Med. 2001;344(3):205–211. doi: 10.1056/NEJM200101183440308. - DOI - PubMed

[5] Pfoh E, Wessels MR, Goldmann D, Lee GM. Burden and economic cost of group A streptococcal pharyngitis. Pediatrics. 2008;121(2):229–234. doi: 10.1542/peds.2007-0484. - DOI - PubMed

[6] Pfoh E, Wessels MR, Goldmann D, Lee GM. Burden and economic cost of group A streptococcal pharyngitis. Pediatrics. 2008;121(2):229–234. doi: 10.1542/peds.2007-0484. - DOI - PubMed

[7] World Health Organization. The Current Evidence for the Burden of Group A Streptococcal Diseases. Discussion papers on Child Health. Department of Child and Adolescent Health and Development, WHO. http://whqlibdoc.who.int/hq/ 2005/WHO_FCH_CAH_05.07.pdf. Accessed 25 Nov 2015.

[8] World Health Organization. The Current Evidence for the Burden of Group A Streptococcal Diseases. Discussion papers on Child Health. Department of Child and Adolescent Health and Development, WHO. http://whqlibdoc.who.int/hq/ 2005/WHO_FCH_CAH_05.07.pdf. Accessed 25 Nov 2015.

[9] Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5:685–694. doi: 10.1016/S1473-3099(05)70267-X. - DOI - PubMed

[10] Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5:685–694. doi: 10.1016/S1473-3099(05)70267-X. - DOI - PubMed

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Estimated burden of group a streptococcal pharyngitis among children in Beijing, China

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Estimated burden of group a streptococcal pharyngitis among children in Beijing, China

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