Institute of Environmental Science and Research, Wellington, New Zealand.
Institute of Environmental Science and Research, Wellington, New Zealand; Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
J Infect Public Health. 2024 Nov;17(11):102545. doi: 10.1016/j.jiph.2024.102545. Epub 2024 Sep 17.
Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras, and acute respiratory infections (ARI).
Analyses include national-level surveillance data on iGAS and ARI. Multivariable Poisson regression was used to examine relationships between COVID-19 era and iGAS incidence, and Pearson pairwise correlations were calculated to examine trends between ARI and iGAS.
A sharp increase in iGAS was observed in 2023, with notable increases among children aged under ten years. Indigenous Māori and Pacific peoples were disproportionately affected. emm1 and emm12 were commonly reported in 2022-2023. Compared to pre-pandemic, iGAS decreased significantly during the COVID-19 restrictions era and increased once COVID-19 restrictions were relaxed, after adjusting for ethnicity, sex, and age. ARI was moderately correlated with iGAS (r = 0∙55) in 2022-2023.
Though delayed, NZ's recent iGAS trends mirror those seen in the 2022/2023 multi-country iGAS surge. These findings expand existing research, suggesting a link between the easing of COVID-19 measures, increased ARI circulation, and the rise in iGAS. Continued and improved iGAS surveillance, is needed to better understand iGAS epidemiology and support public health response. iGAS in NZ will become notifiable in late 2024, which should help improve iGAS monitoring and support public health response.
This research received no specific funding, though iGAS surveillance and typing in NZ is funded by the Ministry of Health, which was not involved in the analysis, interpretation, design, or any aspect of this study. No authors were paid to write this manuscript.
自 2022 年 10 月以来，多个高收入国家报告侵袭性 A 组链球菌（iGAS）感染病例增加。本研究描述了 2017 年至 2023 年期间新西兰（NZ）iGAS 感染的趋势，并研究了 iGAS 发病率、新冠疫情时代和急性呼吸道感染（ARI）之间的关联。
分析包括关于 iGAS 和 ARI 的国家级监测数据。采用多变量泊松回归分析新冠疫情时代与 iGAS 发病率之间的关系，并采用皮尔逊两两相关分析计算 ARI 与 iGAS 之间的趋势。
2023 年 iGAS 急剧增加，10 岁以下儿童发病率显著上升。毛利人和太平洋岛民受到的影响不成比例。2022-2023 年常见的血清型为 emm1 和 emm12。与大流行前相比，在调整了种族、性别和年龄因素后，iGAS 在新冠疫情限制时代显著下降，一旦放松新冠疫情限制，iGAS 就会增加。2022-2023 年 ARI 与 iGAS 中度相关（r=0.55）。
虽然有延迟，但新西兰最近的 iGAS 趋势与 2022/2023 年多国 iGAS 激增的趋势相似。这些发现扩展了现有研究，表明新冠疫情措施的放宽、ARI 循环的增加与 iGAS 的上升之间存在联系。需要继续加强和改进 iGAS 监测，以更好地了解 iGAS 流行病学并支持公共卫生应对。2024 年底，新西兰将要求报告 iGAS，这应该有助于改善 iGAS 监测并支持公共卫生应对。
本研究未获得特定资金支持，尽管新西兰的 iGAS 监测和分型由卫生部资助，但卫生部并未参与分析、解释、设计或本研究的任何方面。没有作者为此手稿获得报酬。
