Poster Presentation Lancefield International Symposium for Streptococci and Streptococcal Diseases 2025

Group A Streptococcus molecular point-of-care test performance in remote Australia (#204)

Janessa Pickering 1 , Dylan D Barth 1 , Bernadette Wong 1 , Rebecca Dalton 1 , Delia Lawford 2 , Robyn Macarthur 3 , Shelley Kneebone 3 , Narelle Ozies 3 , Abbey Ford 1 , Gelsa Cinanni 1 , Scott Winslow 1 , Slade Sibosado 4 5 , Liam Bedford 4 , Jonathan Carapetis 4 , Asha C Bowen 1 , on behalf of the Missing Piece Surveillance Study Team 1
  1. Wesfarmers Centre for Vaccine and Infectious Diseases, The Kids Research Institute Australia, Perth, Western Australia, Australia
  2. Broome Regional Aboriginal Medical Service, Broome, Western Australia, Australia
  3. Derby Aboriginal Health Service, Derby, Western Australia, Australia
  4. The Kids Research Institute Australia, Perth, Western Australia, Australia
  5. Kimberley Aboriginal Health Alliance, Broome, Western Australia, Australia

Background

Accurate and timely diagnosis of group A Streptococcal (GAS) pharyngitis in remote settings can be challenging. The availability of molecular point-of-care testing (PoCT) for GAS pharyngitis may revolutionise primary prevention strategies in children at high risk of acute rheumatic fever. We aimed to evaluate the performance of a rapid molecular PoC test for GAS pharyngitis in remote-living children in the Kimberley, Western Australia.

Methods

Our primary school-based prospective surveillance program evaluated the epidemiology of GAS infection in two towns, comprising: (1) cross-sectional screening two times a year, and (2) weekly active surveillance visits once a week. From 20th April 2021 to 21st September 2022, 211 children from two schools in the remote Kimberley region of Australia were screened; those presenting with sore throat symptoms provided throat swabs for molecular POCT and laboratory culture for GAS.

Results

Seventy-five children presented with sore throat symptoms at least once and proceeded to POCT. From these, 183 POCT tests were performed, and matched culture was available for 181 swabs. We report a high POCT sensitivity of 85.0%, specificity of 81.0%, PPV of 35.4% and NPV of 97.7%.

Conclusion

The high sensitivity of molecular GAS tests represents an advantage in detection and early treatment of pharyngitis. We confirm the value and feasibility of molecular PoC testing in remote Australian settings to improve diagnosis and treatment of GAS pharyngitis.