The disease burden of group A streptococcal infections worldwide is extremely high. More than 600 million persons, mostly children, suffer from streptococcal pharyngitis each year. There are 600 thousand cases of invasive disease. More serious are the sequelae of these infections in the form of acute rheumatic fever and rheumatic heart disease. About 15 million children are suffering from rheumatic heart disease, out of these, 6 million in India alone. Streptococcal diseases can be considered as one of the most important groups of neglected communicable diseases in India. There are many reasons for the inability to control GAS diseases in India. Besides poverty and living conditions, inadequate treatment and non-compliance with penicillin secondary prophylaxis after onset of rheumatic fever have all contributed to the high disease burden. The best perspective for controlling this disease is to develop a fast diagnostic test for rheumatogenic streptococci and to develop a region-specific vaccine against group A streptococci.
Prerequisite for diagnostic and vaccine development is in-depth understanding of streptococcal diseases in Indian scenario. Data on the epidemiology of all GAS diseases, the characterization of the circulating strains in different regions of India, determination of genetic predisposition markers in different ethnic populations of India and immunological data to identify region-specific vaccine candidates are urgently needed. The major objective of this proposal is to pull together such information in a comprehensive way which will then form the basis of a novel diagnostic test for rheumatogenic streptococci and for the identification of candidates to develop a region-specific vaccine, using state-of-the-art technologies already established in Europe. This proposal is the first comprehensive approach to understand streptococcal diseases and would contribute towards solving a major health problem in India.
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