AN EPIDEMIC OF ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS AMONG ABORIGINAL CHILDREN

Objective: To describe an epidemic of acute post-streptococcal glomeru lonephritis (APSGN) that occurred in Aboriginal children in three remo te Aboriginal communities in Far North Queensland between July and Oct ober, 1993. Methodology: Children at the communities aged between 2 an d 14 years were screened so as to identify all cases of APSGN. Parente ral penicillin was administered to all 583 children who presented for the screening procedure. Results: APSGN was diagnosed in 58 (10%) of t he 583 children. A further 142 (24%) children had microscopic haematur ia. Children aged 5-8 years had the highest APSGN attack rate, and the highest prevalence of microscopic haematuria. Of all 583 children, 34 % had skin sores, and group A streptococci (GAS) were isolated from 71 % of the skin swabs. The prevalence of both skin sores and GAS were gr eater in the children with APSGN, and in those with microscopic haemat uria, than in children with normal urine. A marked decline in the numb er of cases of APSGN occurred after the mass administration of penicil lin. Conclusions: The epidemic of APSGN was associated with GAS skin i nfections. The mass use of penicillin may have had an effect in reduci ng the transmission of the nephritogenic strain of GAS. Microscopic ha ematuria was a significant finding in many of the children, and furthe r prospective studies are required to understand the significance of t his finding.