What is the global prevalence of acute poststreptococcal glomerulonephritis (APSGN)?

Updated: Dec 05, 2018
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Globally, as many as 50% of cases may be subclinical, although it is known that APSGN continues to have a wide distribution. A high percentage of affected persons have mild disease and are asymptomatic (estimates of the ratio of asymptomatic to symptomatic patients vary from 2:1 to 3:1); thus, the actual incidence of the disease is not known.

In developing countries APSGN, usually occurs in children, predominately males and often as epidemics. APSGN usually occurs as sporadic cases, but epidemic outbreaks have taken place in communities with densely populated dwellings that have poor hygienic conditions with a high incidence of malnutrition, anemia, and intestinal parasites. In certain regions, epidemics may occur in cyclical outbreaks every 5-7 years for unknown reasons.

A strong seasonal variation is also noted; sporadic APSGN following upper respiratory tract infection, pharyngitis, and tonsillitis is more common in winter and spring in temperate areas, whereas skin infections are commonly found to precede APSGN in the more tropical and subtropical areas, with a peak incidence during summer and autumn.

A nationwide study in New Zealand was conducted to define epidemiology and clinical features of APSGN in children hospitalized with the illness. The study found higher incidence in socio-economically deprived children as well as with Pacific and Maori children. [36]


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