Shamil Barsenga, Habtamu Miteku, Tewodros Tesfa, Tadesse Shume
Background: Group a streptococcus has been recognized as an important human pathogen and it remains among the top ten causes of mortality from an infectious disease. Group a streptococcus throat carriage plays an important role in the development of infection and transmission to contacts. In Ethiopia, there is little information about screening of children for Group a streptococcus carriage.
Objective: This study was aimed to assess the magnitude of throat carriage, associated factors, and antimicrobial susceptibility pattern of Group a streptococcus among healthy school children in Jigjiga city, Eastern Ethiopia from 12 April to 27 May 2021.
Method: A cross-sectional study was conducted among 462 healthy school children in ages ranging from 7 to 14 years. The throat sample was collected using a sterile cotton swab. Identification of Group a streptococcus was done by colony characteristics, gram staining, catalase negativity, bacitracin sensitivity and Pyrrolidone acrylamides tests. Antibiotic susceptibility test was done on Muller-Hinton agar containing 5% sheep blood by modified Kirby-Bauer disc diffusion method. Data on socio-demographic and related characteristics were gathered through interviews using a questionnaire. The data were double-checked, coded, cleaned, and entered onto Epidotic Version 3.1 then exported to SPSS version 26.0 for analysis. Bivariate and multivariable logistic regression was used to determine the relationship between outcome and predictor variables. A p-value <0.05 was taken as statistically significant.
Results: The overall prevalence of Group a Streptococcus carriage was 10.6% (95% CI; 8.1%-13.7%). Children who live with a family member with a sore throat (AOR=2.51; 95% CI 1.09-5.73), children who live with a large family (AOR=4.64; 95% CI 1.53-14.1), and children who live with non-immediate families (AOR=3.65; 95% CI 1.39-9.61), showed significant association with Group a Streptococcus carriage. Tetracycline resistance was shown to be high, while antimicrobial drugs such as penicillin, amoxicillin, ceftriaxone, erythromycin, azithromycin, chloramphenicol, and vancomycin were found to be effective. Multi-drug resistance was found in 4.1% of the isolates.
Conclusion: The present study showed a significant throat carriage of Group A Streptococci/S. pyogenes in Jigjiga city school children. Family member with a sore throat, having a large family, and living with non-immediate families have all been identified as independent predictors of carriage prevalence. It is recommended that regular screening and surveillance should be conducted in schools.