Title: Rapid antigen detection testing for diagnosis (RADT) of group a streptococcus (GAS) in children (Tamariki)
Abstract:
Rheumatic fever is an autoimmune disease evolving from a GAS pharyngitis infection (Sika-Paotonu et al., 2017). It is a serious, potentially life-threatening illness and is preventable with early detection and intervention. Te Whatu Ora – Health New Zealand is concerned about rates of rheumatic fever among M?ori and Pasifika children, which result from the complications of untreated or undiagnosed GAS pharyngitis (Ministry of Health, 2019). Current practice test for GAS testing involves taking throat swabs from students with sore throats, which are sent to the nearest laboratory for culture. The advantage of sending a throat culture to the laboratory is the ability to detect GAS from small amounts of bacteria on the swab. A limitation of this approach is the waiting time for results, which can take three to five days (Cohen et al., 2013). The waiting time for throat-swab results puts the student and close contacts at risk of spreading GAS pharyngitis infection.
The aim of this study was to evaluate the use of rapid antigen detection tests to provide timely service for the diagnosis and treatment of group A streptococcus (GAS) positive results for children experiencing pharyngitis symptoms. For this study, meta-ethnography was the approach used to synthesize the findings of published research on this subject.
This review found there were advantages to using rapid antigen detection testing for GAS infection – these included reducing the spread of GAS infection and reducing rheumatic fever admission rates. The synthesis of the studies identified three key elements: closure of time gaps; antibiotic stewardship; and quality assurance. This synthesis of research studies found that RADT testing improved outcomes for children with illnesses associated with GAS infection. It also decreased the severity of illness by allowing early intervention with antibiotics. The introduction of RADT testing may help reduce some of the barriers that exist in the current throat-swabbing practice guidelines, and in turn, may reduce overall rheumatic fever rates.
Audience Take Away Notes:
- Rapid antigen detection testing improves the management of Group A Streptococcus infection and supports early diagnosis and treatment. Improved diagnostic accuracy
- Alternative diagnostic tools such as Rapid Antigen testing for Group A Streptococcus could improve service delivery and treatment regime by closing the gaps in waiting time for GAS results
- Health professionals can differentiate between viral and bacterial throat infections. RADT testing reduces the use of inappropriate antibiotic prescribing and decreases the risk of antimicrobials Health professionals can differentiate between viral and bacterial throat infections with
- The use of point-of-care testing allows for the best treatment decisions to be made at the time of the consultation, thus saving time, reducing referrals, and increasing the efficiency of patient care
- RADT test reduces transporting swabs to and from laboratories including laboratory fees to process the swab culture
