Nasopharyngeal Carriage of Streptococcus pneumoniae and Associated Factors among Children in Southwest Ethiopia

Abstract

Background: In Ethiopia, Streptococcus pneumoniae is the predominant causative agent of pneumonia. About, 95% of bacterial pneumonia cases in under five years of children are caused by pneumococci. Objective: To assess the nasopharyngeal carriage of Streptococcus pneumoniae, its antibiotic susceptibility pattern, and associated factors among children in Southwest Ethiopia. Methods: A cross-sectional study was conducted from October 01, 2018, to December 30, 2018. A total of 293 children aged ≤15 years were included in the study using a systematic random sampling technique. A nasopharyngeal swab was collected using a sterile cotton swab and cultured on blood agar supplemented with 5μg/ml gentamicin. The antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion technique. Results: The ages of participants ranged from 5 months to 14 years. The carriage rate of Streptococcus pneumoniae was 74/293 (25.3%). Being within the age group <3 years, the habit of sleeping with parent(s)/guardians and numbers of rooms per household were significantly associated with pneumococcal carriage. Streptococcus pneumoniae showed the highest resistance to Tetracycline, 36 (48.65%), and Trimethoprim/sulfamethoxazole, 29 (39.2%), and was found to be susceptible to Chloramphenicol, 54 (77%), and Erythromycin, 38 (51.4%). Conclusion: The nasopharyngeal carriage rate of Streptococcus pneumoniae is considerably high. High antimicrobial resistance of Streptococcus pneumoniae against Tetracycline and Trimethoprim/sulfamethoxazole was observed. Living in a house with a single room, children’s habit of sleeping with parents/guardians and age are associated factors of high pneumococcal carriage. Strategies need to be designed to address the modifiable associated factors and the bacterium antibiotic resistance pattern should be monitored regularly.

Streptococcus pneumoniae among the children of Aden, Yemen: a cross-sectional report of post-pneumococcal conjugate vaccine

“…It was consistent with results reported from low-and middle-income Middle Eastern countries, and higher than that found in developed countries [12,17,27,31,32]. We observed a high possibility of cross-infection among children who shared a room for sleeping or belonged to households that had only one room per family, and had a low income, as documented in previous research [4,33,34].…”

“…Streptococcus pneumoniae (pneumococci) are upper airway commensals and have a complex relationship with their host [1,2]. Their carriage increases from 9% in infancy to 43% in childhood due to many factors [3,4]. Asymptomatic carriage in the nasopharynx is crucial for transmission and precedes invasive pneumococcal diseases [1,2,5].…”

Prevalence, Antimicrobial Drug Resistance and Associated Risk Factors of Streptococcus Pneumoniae Bacteria Infection Among Under-Five Children With Acute Lower Respiratory Tract Infection Attending Sheik Hassan Yebere Referral Hospital, Jig-Jiga, Ethiopia

“…This result was higher than previous studies conducted in East Africa and Munesa district where under-five children with history of respiratory infection in the upper airway was significantly associated with infection of S. pneumoniae with an AOR of 2.62 and 4.2, respectively. 15 , 34 This difference from the study done in East Africa could be due to the study design used; our study was done using a cross-sectional design but the previous study was done by systematic review and meta-analysis. The other difference regarding the study done in Munesa was that it was conducted in a community-based setting but our study was hospital based.…”

“… 33 Similarly, on the other side of Munesa district, children living in houses with more than two windows were 95% protected from S. pneumoniae infection. 15 Poor ventilation can have a serious health impact due to prolonged exposure to bacteria, which means that lower air exchange rate might increase the concentration of the S. pneumoniae bacteria.…”

“… 10 Similarly, in the Mizan Tepi University teaching hospital prevalence was 25.3% and in Harar, in the eastern part of the country, it was 11.2%. 14 , 15 …”