Invasive and non-invasive group A β-haemolytic streptococcal infections in patients attending public sector facilities in South Africa: 2003–2015

Figures & data

Table 1: Year of isolation, age and sex of the 10 091 cases with invasive and non-invasive group A streptococcal infection, South Africa, 2003–2015.

Year of isolation	N (%)
2003	1 079 (10.7)
2004	915 (9.1)
2005	931 (9.2)
2006	959 (9.5)
2007	640 (6.3)
2008	301 (3.0)
2009	571 (5.7)
2010	628 (6.2)
2011	683 (6.8)
2012	521 (5.2)
2013	213 (2.1)
2014	1 863 (18.5)
2015	786 (7.8)
Patient age, years
<18	2 920 (29)
19 – 64	5 902 (59)
≥65	1 199 (12)
Sex#
Male	5 080 (51.4)
Female	4 809 (48.6)

N: number; GAS: Group A Streptococcus^.

# Where data were reported.

Table 2: Source of isolates taken from the 10 091 patients with invasive and non-invasive group A streptococcal infection, South Africa, 2003–2015.

Source of Isolate	N (%)
Invasive GAS*	1 646 (16)
Other aspirates	194 (1.9)
Joint aspirate	41 (0.4)
Blood culture	900 (8.9)
Cerebrospinal fluid	63 (0.6)
Pleural fluid	121 (1.2)
Biopsy	9 (0.1)
Intra-abdominal fluid	36 (0.4)
Other sites (≤5 cases)	282 (2.8)
Non-invasive GAS*	8 445 (84)
Eye	56 (0.6)
Vaginal swab	72 (0.7)
Throat swab	82 (0.8)
Wound swab	147 (1.5)
Sputum	142 (1.4)
Ear swab	366 (3.6)
Burn swab	474 (4.7)
Pus swab	6421 (63.6)
Urine
Other sites (≤5 cases)	562 (5.6)
	123 (1.2)

* Data shown for sites where number of isolates > 5 per site.

N: number; GAS: Group A Streptococcus.

Figure 1: GAS isolation by Province.

Figure 2: Annual GAS incidence rates among 5 256 patients with invasive and non-invasive group A streptococcal infection, Eastern Cape, South Africa, 2003–2015.

Table 3: Mean age-specific incidence rates of GAS, Eastern Cape, 2003–2015.

	Age Category (yr)			Total
	<18	18 – 64	≥65	Mean IR
All GAS n (%)	1 474 (28)	3 014 (58)	722 (14)	5 210 (100)
IR (per 10^5 py)	3.62	7.29	14.06	6.00
Invasive GAS n (%)	153 (36)	214 (51)	53 (13)	420 (100)
IR (per 10^5 py)	0.38	0.52	1.03	0.48
Non-invasive GAS n (%)	1 321 (28)	2 800 (58)	669 (14)	4 790 (100)
IR (per 10^5 py)	3.24	6.77	13.03	5.48

Yr: years; n: number; IR: Incidence rate; py: person-years. Age data were not available for n = 31 (0.99%).

Figure 3: Annual Incidence rates of invasive and non-invasive group A streptococcal (GAS) infection. Eastern Cape, South Africa, 2003–2015.

Table 4: Mann-Kendall trend test and Sen slope estimation for GAS infection in the public sector over a 13-year period (Eastern Cape).

GAS infection	Mann-Kendall	Sen estimation (median change (95% CI))
Invasive GAS	p = 0.2	−0.01 (-0.03 to 0.01)
Non-invasive GAS	p = 0.002	−0.65 (-0.82 to −0.50)

CI: confidence interval.