Alyssa DeWyer1, Amy Scheel2, Allison R Webel3, Chris T Longenecker4, Jennipher Kamarembo5, Twalib Aliku6, Mark E Engel7, Asha C Bowen8, Freddie Bwanga9, Ian Hovis10, Aileen Chang11, Rachel Sarnacki10, Craig Sable10, James B Dale12, Jonathan Carapetis8, Joselyn Rwebembera6, Emmy Okello6, Andrea Beaton13. 1. Children's National Health System, Department of Cardiology 111 Michigan Ave NW, Washington DC, USA. Electronic address: Adewyer1@jhu.edu. 2. Emory University School of Medicine, Atlanta, Georgia, USA. 3. Frances Payne Bolton School of Nursing Case Western Reserve University, Cleveland, Ohio. 4. University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland, Ohio, USA. 5. Gulu Regional Referral Hospital, Gulu, Uganda. 6. Uganda Heart Institute, Mulago Hospital Complex, Kampala, Uganda. 7. Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. 8. University of Western Australia, Perth, WA; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA; Perth Children's Hospital, Perth, WA. 9. Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda. 10. Children's National Health System, Department of Cardiology 111 Michigan Ave NW, Washington DC, USA. 11. Department of Dermatology, University of California, San Francisco, 505 Paranassus Avenue, San Francisco, CA, 94143, USA. 12. Medicine, University of Tennessee, Memphis, TN, USA. 13. Cincinnati Children's Hospital Medical Center, Cincinnati Ohio, USA.
Abstract
OBJECTIVES: Group A β-hemolytic Streptococcus (GAS), also known as Streptococcus pyogenes, is responsible for an annual 600 million cases of acute pharyngitis globally, with 92% of those infections occurring in low-resource settings. Further knowledge of the acute streptococcal pharyngitis burden in low-resource settings is essential if serious post-streptococcal complications - rheumatic fever (RF) and its long-term sequel rheumatic heart disease (RHD) - are to be prevented. METHODS: Two studies were conducted in school-aged children (5-16 years): a cross-sectional study of streptococcal pharyngeal carriage followed by a prospective cohort study of streptococcal sore throat over 4 weeks from March to April 2017. RESULTS: The cross-sectional study revealed an overall prevalence of GAS carriage of 15.9% (79/496, 95% confidence interval 12.8-19.5%). Among 532 children enrolled in the prospective cohort study, 358 (67%) reported 528 sore throats, with 221 (41.1%) experiencing at least one GAS-positive sore throat. The overall GAS-positive rate for sore throat was 41.8% (221/528). CONCLUSIONS: The GAS pharyngeal carriage rates seen in Uganda (15.9%, 95% confidence interval 12.8-19.5%) are higher than the most recent pooled results globally, at 12% (range 6-28%). Additionally, pilot data suggest a substantially higher percentage of sore throat that was GAS-positive (41.8%) compared to pooled global rates when active recruitment is employed.
OBJECTIVES: Group A β-hemolytic Streptococcus (GAS), also known as Streptococcus pyogenes, is responsible for an annual 600 million cases of acute pharyngitis globally, with 92% of those infections occurring in low-resource settings. Further knowledge of the acute streptococcal pharyngitis burden in low-resource settings is essential if serious post-streptococcal complications - rheumatic fever (RF) and its long-term sequel rheumatic heart disease (RHD) - are to be prevented. METHODS: Two studies were conducted in school-aged children (5-16 years): a cross-sectional study of streptococcal pharyngeal carriage followed by a prospective cohort study of streptococcal sore throat over 4 weeks from March to April 2017. RESULTS: The cross-sectional study revealed an overall prevalence of GAS carriage of 15.9% (79/496, 95% confidence interval 12.8-19.5%). Among 532 children enrolled in the prospective cohort study, 358 (67%) reported 528 sore throats, with 221 (41.1%) experiencing at least one GAS-positive sore throat. The overall GAS-positive rate for sore throat was 41.8% (221/528). CONCLUSIONS: The GAS pharyngeal carriage rates seen in Uganda (15.9%, 95% confidence interval 12.8-19.5%) are higher than the most recent pooled results globally, at 12% (range 6-28%). Additionally, pilot data suggest a substantially higher percentage of sore throat that was GAS-positive (41.8%) compared to pooled global rates when active recruitment is employed.
Authors: Kate M Miller; Jonathan R Carapetis; Chris A Van Beneden; Daniel Cadarette; Jessica N Daw; Hannah C Moore; David E Bloom; Jeffrey W Cannon Journal: EClinicalMedicine Date: 2022-05-20
Authors: Joselyn Rwebembera; Bruno Ramos Nascimento; Neema W Minja; Sarah de Loizaga; Twalib Aliku; Luiza Pereira Afonso Dos Santos; Bruno Fernandes Galdino; Luiza Silame Corte; Vicente Rezende Silva; Andrew Young Chang; Walderez Ornelas Dutra; Maria Carmo Pereira Nunes; Andrea Zawacki Beaton Journal: Pathogens Date: 2022-01-28