Assessment of Different Clinical Variables Associated with Group A Streptococcal Throat Infection among Children in Primary Care Practice

Abstract

Background: Group A streptococcus (GAS) is a major cause of morbidity and mortality worldwide. An effective targeting strategy is needed for appropriate antibiotic prescriptions for GAS sore throat. Objective: This study aimed to assess different clinical variables that can guide management of acute sore throat in children. Methods: A diagnostic cross-sectional study was conducted on 225 children, aged ≥ 3 years ,with acute sore throat attending two primary care clinics in Cairo, Egypt. Demographic information, clinical data and throat swabs were collected from the patients after consent from the parents. Results: The mean age of the children was 5.8 years and almost half of them were males, and had on average 3 attacks of sore throat per year. Out of the 225 children 64 (28.4%) had positive GAS cultures and 183 (81.3%) received antibiotics. Of the 183 who received antibiotics, 128 (69.9%) had cultures negative for group A Streptococcus. There was little difference between those with and without GAS for commonly assessed clinical variables such as the absence of cough. The absence of skin rash was the only variable that was statistically significant (92% and 98% respectively, p<0.05) Conclusion: Clinical variables associated with acute sore throat in Egyptian children cannot accurately diagnose GAS throat infection.