Improving public health surveillance systems for acute post-streptococcal glomerulonephritis in Far North Queensland, Australia
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Torres and Cape Hospital and Health Service, Australia
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1942
ABSTRACT
Background and Objective:
Acute post-streptococcal glomerulonephritis (APSGN) is an immune-mediated inflammatory disease of the kidneys that occurs approximately three weeks after a skin or throat infection with Group A Streptococcus. In Australia it is predominately a disease of socio-economic disadvantage with high rates in First Nations children. This disease is not currently notifiable within the Australian state of Queensland making it challenging to ensure an appropriate public health response to cases, identify outbreaks and monitor epidemiological trends. The aim of this abstract is to describe the results of a locally implemented ASPGN surveillance system.
Methods:
In 2022, public health surveillance of APSGN in the Torres and Cape was augmented by a digital health alert system to which automatically notifies the public health team of suspected cases. APSGN cases in the one year following implementation were compared to annual case estimates from a retrospective, de-identified internal audit of electronic medical records between 2005 and 2021. Incidence rates were calculated and stratified by case definition (confirmed or probable cases) and location.
Results:
Between 2005 and 2021 there were 172 reported APSGN cases across the Torres and Cape region (141 confirmed and 31 probable), suggested a mean of 10.1 cases per year. There have been seven outbreaks during the audit period. There were 15 cases identified across the region during the one-year following implementation of the APSGN digital health alert system (8 confirmed and 7 probable), with no outbreaks declared.
Conclusion:
The extent to which these data suggest an increase in APSGN incidence across the region or an increase in case ascertainment is not clear. Although this simple surveillance system has improved the local public health response, mandating notification of APSGN under Queensland public health legislation will help raise the profile of this disease of disadvantage and stimulate better public health policy.