Prevalence of group a streptococcus pharyngeal carriage and clinical manifestations in school children aged 5-15 yrs in Wakiso District, Uganda

BMC Infect Dis. 2017 Apr 5;17(1):248. doi: 10.1186/s12879-017-2353-5.

Abstract

Background: Beta-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.

Methods: A 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.

Results: The 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.

Conclusion: There is a high prevalence of GAS pharyngeal carriage among children aged 5-15 years attending primary schools in Wakiso District, Uganda.

Keywords: Carriage; Group a streptococcus; Uganda.

MeSH terms

  • Adolescent
  • Bacterial Proteins
  • Carrier State / epidemiology
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Pharynx / microbiology*
  • Poverty
  • Prevalence
  • Rural Population
  • Schools
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / physiopathology
  • Streptococcus pyogenes*
  • Streptolysins
  • Surveys and Questionnaires
  • Uganda / epidemiology

Substances

  • Bacterial Proteins
  • Streptolysins
  • streptolysin O