Prevalence of Group A beta‐haemolytic Streptococcus isolated from children with acute pharyngotonsillitis in Aden, Yemen

Abstract

Abstractobjectives To estimate the prevalence of Group A beta-haemolytic streptococcus (GAS) and non-GAS infections among children with acute pharyngotonsillitis in Aden, Yemen, to evaluate the value of a rapid diagnostic test and the McIsaac score for patient management in this setting and to determine the occurrence of emm genotypes among a subset of GAS isolated from children with acute pharyngotonsillitis and a history of acute rheumatic fever (ARF) or rheumatic heart disease (RHD).methods Group A beta-haemolytic streptococcus infections in school-aged children with acute pharyngotonsillitis in Aden, Yemen, were diagnosed by a rapid GAS antigen detection test (RADT) and/or GAS culture from a throat swab. The RADT value and the McIsaac screening score for patient management were evaluated. The emm genotype of a subset of GAS isolates was determined.results Group A beta-haemolytic streptococcus pharyngotonsillitis was diagnosed in 287/691 (41.5%; 95% CI 37.8-45.3) children. Group B, Group C and Group G beta-haemolytic streptococci were isolated from 4.3% children. The RADT had a sensitivity of 238/258 (92.2%) and specificity of 404/423 (95.5%) against GAS culture. A McIsaac score of ≥4 had a sensitivity of 93% and a specificity of 82% for confirmed GAS infection. The emm genotypes in 21 GAS isolates from children with pharyngitis and a history of ARF and confirmed RHD were emm87 (11), emm12 (6), emm28 (3) and emm5 (1).conclusion This study demonstrates a very high prevalence of GAS infections in Yemeni children and the value of the RADT and the McIsaac score in this setting. More extensive emm genotyping is necessary to understand the local epidemiology of circulating strains.

Prevalence of group A β-haemolytic Streptococcus among children with pharyngitis in Jimma town, Southwest Ethiopia

“…Such indiscriminate use of antibiotics might contribute for the low carriage rate of GAS in the community. Similarly, 11.3% prevalence of GAS in our study was lower than the findings in Egypt, 22 Tunisia, 23 Yemen, 24 Brazil 25 and USA 26 where average prevalence of 17-58% was reported. Such variation may be due to differences in methodology, seasons of sample collection and geographical variation of study settings.…”

“…Similar findings were revealed in Canada, 30 USA 31-33 and Yemen. 24 However, it is important to know that the clinical variables that are predictor for GAS infection may vary with different GAS strains, geographic area and immunity profile of the study population. 22 …”

GROUP A beta-hemolytic streptococcal pharyngitis and carriage rate among Egyptian children: a case-control study

“…Similar high rates (40% and 41.5%) of GAS pharyngitis have also been reported in other studies from Arab countries. 11 , 12 Previous studies on the prevalence of GAS in Egyptian children with sore throat reported that 24% 13 and 31.6% 14 had a positive throat culture. The high rate of GAS infection in our study may be due to the exclusion of children younger than 4 years old.…”

Use of Bionexia Strep A Plus Rapid Antigen Test in the Identification of Group A Beta-Hemolytic Streptococci in Throat Swab Samples

“…Mısır'da 4-16 yaş arası hastaları kapsayan bir çalışmada ise GAS prevalansı %42.2 olarak bildirilmiştir (17) . Arap ülkelerinde de benzer yüksek prevalans oranlarının (%40-%41.5) bulunduğu çalışmalar yapılmıştır (18,19) . Ülkemizde, 0-18 yaş arası hastaları kapsayan bir çalışmada, GAS prevalansı %25 olarak belirlenmiş, bir başka çalışmada da prevalans benzer şekilde %24.6 bulunmuştur (6,20) .…”