Isolation of group A beta-hemolytic streptococci in the tonsillopharynx of school children in Madras City and correlation with their clinical features.

Today, rheumatic fever is the most common cause of heart disease in children and young adults, and it accounts for about half of all cardiovascular diseases causing death in the first four decades of life, in India. In the present study, conducted during 1991-1992 at Chennai, India, a total of 666 school girls aged 5-15 years were examined clinically for one or more of the following signs and symptoms: repeated sore throat, joint pain/swelling, epistaxis, chest pain, breathlessness, palpitation, abdominal pains, etc. Out of the 666 children screened, 124 were recruited for the present study, based on their meeting one or more of the above mentioned clinical criteria. They were screened for the presence of group A beta-hemolytic streptococci, and for antistreptolysin O and C-reactive protein. Thus, the aim of the present study was to reduce the load of streptococcal infection and the consequent risk of developing rheumatic fever and rheumatic heart disease. In the present study group, 89.5% of the children indicated a history of repeated sore throat. However, only 4.0% of the children in the study group were positive for group A beta-hemolytic streptococci. The antistreptolysin O and C-reactive protein levels were higher in 11- to 15-year-old patients than in 5- to 10-year-old patients in the study group.