{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:28:00Z","timestamp":1793647680738,"version":"4.5.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"James Cook University","id":[{"id":"https:\/\/ror.org\/04gsp2c11","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Invasive Group A Streptococcus (iGAS) is an important cause of severe bacterial infection with increasing incidence and substantial socioeconomic disparities. This study quantified long-term trends, spatial distribution, and determinants of iGAS incidence in Northern Queensland, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A population-based retrospective cohort study was conducted using linked hospital data linkage from 2000\u20132020. Incidence rates were calculated per 100,000 person-years and temporal trends were assessed. Spatial clustering was evaluated using Moran\u2019s I statistic for spatial autocorrelation. Determinants of incidence were examined using a negative binomial generalized additive model (GAM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 933 iGAS events were identified among 870 individuals. Incidence increased substantially over time, with the highest rates observed among older adults and a secondary peak among infants. Age-standardised incidence was approximately nine-fold higher among Indigenous compared with non-Indigenous populations for both males and females. Spatial analysis demonstrated significant clustering of incidence (Moran\u2019s I\u2009=\u20090.19, p\u2009&lt;\u20090.001), with the greatest burden occurring in remote and very remote regions. In multivariable analysis, Indigenous status (IRR\u2009=\u20098.97, p\u2009&lt;\u20090.001) and male sex (IRR\u2009=\u20091.28, p\u2009&lt;\u20090.001) were independently associated with higher incidence. Smooth terms showed significant nonlinear effects of age (edf\u2009=\u20097.45, p\u2009&lt;\u20090.001) and calendar year (edf\u2009=\u20098.04, p\u2009&lt;\u20090.001), indicating heterogeneous age patterns and temporal acceleration in incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>iGAS incidence in Northern Queensland increased markedly over two decades and was characterised by pronounced geographic and Indigenous health inequities, highlighting the need for targeted prevention strategies in high-risk populations and regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02904-w","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:25:57Z","timestamp":1787642757000},"page":"2681-2690","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emerging epidemiology of invasive group a Streptococcus in tropical Australia: a 21-year population-based data linkage study"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0132-806X","authenticated-orcid":false,"given":"Himali Erandathie","family":"Ratnayake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8987-4358","authenticated-orcid":false,"given":"Damon","family":"Eisen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9793-8024","authenticated-orcid":false,"given":"Oyelola","family":"Adegboye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-5873","authenticated-orcid":false,"given":"Anton","family":"Pak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9570-9172","authenticated-orcid":false,"given":"Emma","family":"McBryde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"12","key":"2904_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0168177","volume":"11","author":"J Ibrahim","year":"2016","unstructured":"Ibrahim J, Eisen JA, Jospin G, Coil DA, Khazen G, Tokajian S. 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