Urban and Rural Disparities in Pneumococcal Carriage and Resistance in Jordanian Children, 2015–2019

Abstract

Background: A pneumococcal carriage surveillance study took place examining Jordanian children in urban and rural areas in the period 2015–2019. Objectives: To determine urban and rural differences in pneumococcal carriage rate, resistance, and serotypes among healthy Jordanian children from Amman (urban) and eastern Madaba (rural). Methods: Nasopharyngeal swabs (NP) were taken from 682 children aged 1 to 163 months. Pneumococcal identification, serotyping, and resistance were performed according to standard method. Results: The number of cases tested for Amman was 267 and there were 415 cases tested for eastern Madaba. Carriage rate for eastern Madaba was 39.5% and 31.1% for Amman. Predominant serotypes for eastern Madaba and Amman were 19F (21.3%; 15.7%), 23F (12.2%; 9.6%), 14 (6.7%; 2.4%), 19A (4.9%; 2.4%), and 6A (5.5%; 3.6%). Resistance rates for eastern Madaba and Amman were as follows: penicillin (95.8%; 81.9%), clarithromycin (68.9%; 59.0%), clindamycin (40.8%; 31.3%), and trimethoprim-sulfamethoxazole (73.2%; 61.4%). Coverage of PCV7, PCV13, and the future PCV20 for Amman was 42.2%, 48.2%, and 60.2%; for eastern Madaba, coverage was 50.0%, 62.2%, and 73.2%, respectively. In Amman 25.8% of children received 1–3 PCV7 injections compared to 1.9% of children in eastern Madaba. Conclusions: There were significant differences in carriage, resistance, and coverage between both regions. The potential inclusion of a PCV vaccination program for rural areas is essential.

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

“…A higher penicillin resistance (meningitis breakpoint) was found in the current study (96.5%), and it was slightly higher than that reported in the previous study [29]. This finding was in line with recently reported data from Jordan (94.4-95.8%) and Iran (95.3%) [12,42,43]. On other hand, the rate was higher than that found in GCC [44].…”

Prevalence of Pneumococcal Carriage among Jordanian Infants in the First 6 Months of Age, 2008–2016

“…According to the division of statistics of the Ministry of Health of Jordan, the total population count estimated in 2021 was 10,262,521, with an average family size of 6.1 members. This average of family members may attribute to the high carriage rate, in addition to other factors like low income, smoking among family members, history of sicknesses, immune deficiency, viral infections and history of antibiotic consumption [3,7,23,24]. In this study, the average number of siblings per household found was 3.7.…”