Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 5 min ago
Peer-reviewedCC BY 4.0Infection

Emerging epidemiology of invasive group a Streptococcus in tropical Australia: a 21-year population-based data linkage study

  • Himali Erandathie Ratnayake1
  • Damon Eisen1
  • Oyelola Adegboye2,3
  • Anton Pak4
  • Emma McBryde5,6
6 affiliations
  1. 1College of Medicine and Dentistry, James Cook University, Townsville, QLD Australia
  2. 2Menzies School of Health Research, Charles Darwin University, Northern Territory Darwin, Australia
  3. 3Public Health and Tropical Medicine, College of Medicine and Dentistry, James Cook University, Townsville, QLD Australia
  4. 4Centre for Business and Economics of Health, The University of Queensland, Brisbane, QLD Australia
  5. 5Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD Australia
  6. 6Burnet Institute, Melbourne, Victoria Australia
Read full textPDFDOICite

Abstract

Purpose: Invasive Group A Streptococcus (iGAS) is an important cause of severe bacterial infection with increasing incidence and substantial socioeconomic disparities. This study quantified long-term trends, spatial distribution, and determinants of iGAS incidence in Northern Queensland, Australia.

Methods: A population-based retrospective cohort study was conducted using linked hospital data linkage from 2000–2020. Incidence rates were calculated per 100,000 person-years and temporal trends were assessed. Spatial clustering was evaluated using Moran’s I statistic for spatial autocorrelation. Determinants of incidence were examined using a negative binomial generalized additive model (GAM).

Results: A total of 933 iGAS events were identified among 870 individuals. Incidence increased substantially over time, with the highest rates observed among older adults and a secondary peak among infants. Age-standardised incidence was approximately nine-fold higher among Indigenous compared with non-Indigenous populations for both males and females. Spatial analysis demonstrated significant clustering of incidence (Moran’s I = 0.19, p < 0.001), with the greatest burden occurring in remote and very remote regions. In multivariable analysis, Indigenous status (IRR = 8.97, p < 0.001) and male sex (IRR = 1.28, p < 0.001) were independently associated with higher incidence. Smooth terms showed significant nonlinear effects of age (edf = 7.45, p < 0.001) and calendar year (edf = 8.04, p < 0.001), indicating heterogeneous age patterns and temporal acceleration in incidence.

Conclusion: iGAS incidence in Northern Queensland increased markedly over two decades and was characterised by pronounced geographic and Indigenous health inequities, highlighting the need for targeted prevention strategies in high-risk populations and regions.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02904-w.

Related

  1. Motor neuron disease in rural Australia: a population-based observational study of epidemiology, clinical characteristics and regional variation
    A. L. Wright, Z. N. Zussa, S. Chan Moi Fat +7
    medRxivPreprintCC BY-NCFull textEpidemiology & public healthmedRxiv
  2. Outcomes and associated risk factors among hospitalisations attributed to invasive group A streptococcal disease in Northern Queensland, Australia: a 21-year population-based data linkage study
    Himali Ratnayake, Damon Eisen, Oyelola Adegboye +2
    InfectionPeer-reviewedCC BY 4.0Full textEpidemiology & public healthPMC
  3. Invasive Infections Caused by Streptococcus pseudoporcinus: A Two-Case Series and Review of the Literature
    Julio de Jesús Navarro-Yépez, Frida Ximena Macías-López, David Alejandro Trejo-Osornio +2
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  4. Age, period, and cohort effects in the population-level incidence and mortality of cancer types associated with early onset increases in Australia
    Sithum Munasinghe, Kate McBride, Phuong Dung Nguyen +2
    BMC MedicinePeer-reviewedCC BY-NC-ND 4.0OncologyCrossref
  5. Infection prevention and control considerations in invasive group A streptococcus outbreaks.
    Louise Kelly, Saied Ali
    Infection prevention in practicePeer-reviewedCC BY-NC-NDFull textEpidemiology & public healthEurope PMC

Cite

BibTeXRIS
BibTeX
@article{ratnayake2026emerging,
  title = {{Emerging epidemiology of invasive group a Streptococcus in tropical Australia: a 21-year population-based data linkage study}},
  author = {Himali Erandathie Ratnayake and Damon Eisen and Oyelola Adegboye and Anton Pak and Emma McBryde},
  journal = {Infection},
  year = {2026},
  month = aug,
  doi = {10.1007/s15010-026-02904-w},
  url = {https://doi.org/10.1007/s15010-026-02904-w},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Emerging epidemiology of invasive group a Streptococcus in tropical Australia: a 21-year population-based data linkage study
AU  - Himali Erandathie Ratnayake
AU  - Damon Eisen
AU  - Oyelola Adegboye
AU  - Anton Pak
AU  - Emma McBryde
PY  - 2026
DA  - 2026/08/25
JO  - Infection
DO  - 10.1007/s15010-026-02904-w
UR  - https://doi.org/10.1007/s15010-026-02904-w
AB  - Purpose: Invasive Group A Streptococcus (iGAS) is an important cause of severe bacterial infection with increasing incidence and substantial socioeconomic disparities. This study quantified long-term trends, spatial distribution, and determinants of iGAS incidence in Northern Queensland, Australia.  Methods: A population-based retrospective cohort study was conducted using linked hospital data linkage from 2000–2020. Incidence rates were calculated per 100,000 person-years and temporal trends were assessed. Spatial clustering was evaluated using Moran’s I statistic for spatial autocorrelation. Determinants of incidence were examined using a negative binomial generalized additive model (GAM).  Results: A total of 933 iGAS events were identified among 870 individuals. Incidence increased substantially over time, with the highest rates observed among older adults and a secondary peak among infants. Age-standardised incidence was approximately nine-fold higher among Indigenous compared with non-Indigenous populations for both males and females. Spatial analysis demonstrated significant clustering of incidence (Moran’s I = 0.19, p < 0.001), with the greatest burden occurring in remote and very remote regions. In multivariable analysis, Indigenous status (IRR = 8.97, p < 0.001) and male sex (IRR = 1.28, p < 0.001) were independently associated with higher incidence. Smooth terms showed significant nonlinear effects of age (edf = 7.45, p < 0.001) and calendar year (edf = 8.04, p < 0.001), indicating heterogeneous age patterns and temporal acceleration in incidence.  Conclusion: iGAS incidence in Northern Queensland increased markedly over two decades and was characterised by pronounced geographic and Indigenous health inequities, highlighting the need for targeted prevention strategies in high-risk populations and regions.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02904-w.
SN  - 0300-8126
SN  - 1439-0973
ER  -