The rate of asymptomatic throat carriage of Streptococcus pyogenes and its associated risk factors among Kabul University students

Abstract

Streptococcus pyogenes (S. pyogenes) is the main agent of acute pharyngitis and skin infections that may result in the late complications of glomerulonephritis and rheumatic fever. Infection with streptococcus group A is a global health problem, which is most common in children and adults. This study was conducted to investigate the rate of S. pyogenes throat carriers and its main risk factors among healthy students of Kabul university. In the present study pharyngeal swabs of 260, [155 (59.6%) were male and 105 (40.4%) were female] asymptomatic university students aged between 19-30 years, were collected and immediately transported to the laboratory for detection of S. pyogenes following standard microbiological procedures. Production of beta hemolytic colonies on blood agar, sensitivity to bacitracin antibiotic, gram stain positivity, catalase negativity test and streptococcal grouping latex kit (ProlexTM) tests were used to identify and differentiate S. pyogenes from other streptococcus spp. Statistical analysis of data was performed using SPSS 21, Chi-square and Logistic regression tests were applied for the categorical data analysis. A P value equal to or less than 0.05 was considered statistically significant. Totally 61 (23.5%) beta hemolytic streptococci were isolated from 260 samples. Among 61 beta hemolytic isolates, 44 (16.9%) were identified as S. pyogenes. The colonization rate of S. pyogenes was higher in male 25 (56.8%) than female 19 (43.2%), which was not statistically significant (p=0.678). Age, residence of the students at hostel and shared utensil use were not statistically significant (p=0.088, p= 0.449, p=0.241 respectively), but the number of children in the family was an important risk factor. People with 1-3 children had a 23-fold higher risk (p˂0.05), and people with 4-6 children had a 27-fold higher risk of carrying S. pyogenes, than those who did not had any children (p˂0.05). In the present study the asymptomatic throat carriage rate of S. pyogenes among Kabul University students, was high. Among all risk factors the number of children in the family was significantly associated with S. pyogenes throat carriage.

The Rate of Asymptomatic Throat Carriage of Streptococcus pyogenes and its Associated Risk Factors among Medical Students of Queen Arwa University in Sana’a City, Yemen

“…However, our ndings were in disagreement with the results of a previous study in which the prevalence rate of S. pyogenes carriage among adults was reported at 2-46% in Turkey [8], 9.6% in Philadelphia [9], 15.6% in young adult inhabitants of Wielkopolska, Poland [10], between 11.2 to 34% in India [11], 3.6% among pharmacy students in a university in Cyprus [5], 16.9% in Kabul university [12], and 63% among health community in Australia [20].…”

“…It was found that the number of children in the family was an important risk factor. Students with 1-3 children in the family had a 23-fold higher risk of carrying S. pyogenes than those who (p 0.05), and those students who had 4-6 children in their family, had a 27-fold higher risk of carrying S. pyogenes in their throat than those didn't have any children (p 0.05) [12].…”

“…According to the previous studies conducted among adult students in some countries, the prevalence rate of S. pyogenes throat carriage was reported at 2-46% in Turkey [8], 9.6% in Philadelphia [9], 15.6% in Poland [10], 11.2-34% in India [11], 3.6% in Cyprus [5], and 16.9% in Kabul university [12].…”

“…The sample size was calculated by using Epi Info 7 (version 7.2.5) as the subsequent: The total size of medical students is 1593 registered in QAU. According to previous reports, the expected prevalence of S. pyogenes prevalence was 10.03% [5,9,12]. Also, 5% and 5% were set as an acceptable margin of error and con dence level, respectively.…”

“…Individuals who asymptomatically S. pyogenes carriage could play a role in the spread of infection to households and community settings, particularly environments where large crowds get together such as schools, universities, daycare centers, and o ces [5, 6]. The S. pyogenes carriage rate among children can be over 10%, while in adults the reported carriage rate is much lower [7].According to the previous studies conducted among adult students in some countries, the prevalence rate of S. pyogenes throat carriage was reported at 2-46% in Turkey [8], 9.6% in Philadelphia [9], 15.6% in Poland [10], 11.2-34% in India [11], 3.6% in Cyprus [5], and 16.9% in Kabul university [12].In developing nations such as Yemen, overcrowding conditions, lack of health awareness, food insecurity, widespread poverty, and limited access to health services contribute to the prevalence of preventable diseases in the community [13][14][15][16]. Most of earlier studies which conducted in Ymene focused the S. pyogenes among children [6,17].…”