Prevalence and Clinical Presentation of Group A Streptococcal Pharyngitis in Children at a Tertiary Hospital in Gombe, North-East Nigeria

Abstract

Background: Globally, Group A ß-Haemolytic Streptococcus (GAßHS) pharyngitis and its complications are major contributors to childhood morbidity and mortality, especially in developing countries. The diagnosis and treatment of GAßHS pharyngitis in these countries is often empirical resulting in frequent misdiagnosis and inappropriate treatment. Determining the local prevalence and clinical presentations of GAßHS pharyngitis will be essential for making informed clinical decision. Objective: The objective of the study was to determine the prevalence and clinical presentations of GAßHS among children with pharyngitis at a tertiary hospital in Gombe, North-eastern Nigeria. Methods: 324 children aged 3-18 years were consecutively recruited at the out-patient clinic between 1st April 2018 to 30th September 2018. Socio-demographic and clinical features were recorded and throat swab samples were cultured on 5% sheep blood agar to diagnose GAßHS.Result: The prevalence of GAßHS pharyngitis was 25.9% and was significantly higher; in females (67.1%) (p=0.046), in children aged 11-14 years (32.1%) (p= 0.008) and during peak rainfall (p=0.001). The clinical features significantly associated with GAßHS pharyngitis were; runny nose (p<0.001), cough (p<0.001) and sorethroat (p<0.001), fever (p<0.001), palatal petechiae (p<0.001), pharyngeal erythema and exudates (p=0.001), tonsillar enlargement and exudates (p<0.001), cervical lymph node tenderness (p=0.010), halitosis (p=0.029), and scarlet rash (p=0.001). Conclusion: GAßHS pharyngitis is prevalent in children especially during peak of rainfall and some clinical features are commoner among patients with GAßHS pharyngitis. These clinical symptoms and signs can be used to guide empiric treatment decision.