Abstract
BackgroundBeta-hemolytic streptococci carrier rates in children living in low-income countries are high ranging from 10 to 50%. Although most of these children are asymptomatic, they are a reservoir and pose a risk of transmission. The aim of this study was to determine the prevalence of group a streptococcus pharyngeal carriage and clinical manifestations in school going children in Wakiso district, Uganda.MethodsA cross sectional study targeting children age 5–15 years in primary schools in one sub-county of Wakiso district was carried out. Three hundred and sixty-six children from five primary schools were enrolled and evaluated for group a streptococcus (GAS) carriage. A semi-structured questionnaire was used to collect data that included social demographics, school environment and clinical findings. For every enrolled child a throat swab was taken and cultured for GAS and blood was drawn for anti-streptolysin-O titres. Analysis of data was done using STATA.ResultsThe prevalence of GAS carriage was 16%. The children with GAS positive cultures were mainly females. The factor associated with GAS carriage was the school location, with peri-urban schools more likely to have children with GAS compared to rural schools; AOR 2.48 (95% CI: 1.01 – 6.11), P = 0.049. There was no significant difference between the characteristic of children with GAS positive verses GAS negative throat swab cultures.ConclusionThere is a high prevalence of GAS pharyngeal carriage among children aged 5–15 years attending primary schools in Wakiso District, Uganda.
Highlights
Beta-hemolytic streptococci carrier rates in children living in low-income countries are high ranging from 10 to 50%
Pharyngitis caused by group a streptococcus has been linked with the aetiopathogenesis of rheumatic fever (RF) and rheumatic heart disease (RHD) [5]
The aims of this study were to determine the prevalence of Group a beta-hemolytic streptococcus (GAS) pharyngeal carriage, describe the clinical characteristics of the children with GAS and determine factors associated with GAS pharyngeal carriage in school going children in Sissa sub-county, Wakiso district, Uganda
Summary
Beta-hemolytic streptococci carrier rates in children living in low-income countries are high ranging from 10 to 50%. Most of these children are asymptomatic, they are a reservoir and pose a risk of transmission. Group a beta-hemolytic streptococcus (GAS) has been estimated to account for between 20 to 40% of all cases of pharyngitis in children [1]. There are 450 million estimated cases of GAS pharyngitis in children each year worldwide [2]. GAS pharyngitis is ubiquitous but is more frequent in low-income countries. The most common bacterial cause of pharyngitis, has a peak incidence in children 5–15 years of age [5]. Primary prevention relies on the eradication of group a streptococcal carriage through active sore throat screening and by treatment of pharyngitis with oral antibiotics [6]
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