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The inequitable burden of group A streptococcal diseases in Indigenous Australians

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We need to fill evidence gaps and make clinical advances to reduce these diseases of disadvantage

Group A streptococcal (GAS) infections contribute to the excess burden of ill-health in Indigenous Australians, causing superficial infection, invasive disease, and the autoimmune sequelae of acute rheumatic fever (ARF) and acute post-streptococcal glomerulonephritis (APSGN) (Box 1).16 GAS diseases declined in the broader Australian population during the 20th century, largely as a result of improved living conditions,7 but this is not the case in Indigenous Australians. GAS infections and their sequelae persist at unacceptably high rates in remote Australia, on par with or higher than those in low income settings internationally.8 GAS infections globally represent social disadvantage.5,8 Poverty, household overcrowding and distance from health care services are the main drivers.9

GAS impetigo

In remote Australian communities, impetigo, predominantly caused by GAS infection,2,10,11