Keywords:
acute rheumatic fever; group A streptococcus; participatory action research
Abstract:
Background:
‘Check4Strep’ is a community-based, participatory action research (PAR) pilot study in a remote northern territory community.
Aim:
Its purpose is to co-design methods for studying Strep A burden and transmission that are acceptable and beneficial to community members. A better understanding of Strep A transmission pathways could inform treatment and primordial and primary ARF prevention through public health advice.
Methods:
Activities are conducted according to the ‘Plan–Act–Observe–Reflect’ (PAR) cycle. Up to 80 individuals will be enrolled during community swabbing days, with detection of ~10 positive Strep A samples anticipated. Participants will be invited to consent for swabs of the throat, purulent/crusted skin lesion (if present), palmar surface, nasal discharge (if present), and clothing. Swabs will be dispatched for culture and, if Strep A-positive, genomic sequencing; duplicate swabs will be collected from throats for point-of-care testing (Abbott ID NOW S. pyogenes). To infer transmissibility from the throat, cough samples will be obtained using an agar plate held 20 cm from the mouth, plus an air sampler (Coriolis Micro Air Sampler, Bertin Technologies, Paris, France) at 250 L/min. Community researchers will complete demographic and social network surveys and co-facilitate knowledge sharing around Strep A transmission.
Results:
Outcomes from implementing the initial PAR cycle will be presented, including consultation with community members and organisations, the employment of community-based researchers, and two-way information sharing about Strep A, including traditional remedies, the design and testing of community sample collection activities, and preliminary microbiology results.
Conclusions:
‘Check4Strep’ will demonstrate Strep A recovery rates from different sample types and achieve effective knowledge sharing and two-way capacity building to form the basis of a longitudinal study.