Factors Associated with Colonization of Streptococcus Pneumoniae Among Under-Fives Attending Reproductive and Child Health Clinics in Mwanza City, Tanzania.
Material type:
TextPublisher number: Phone: +255 28 298 3384 Fax: +255 28 298 3386 Email: vc@bugando.ac.tz Website: www.bugando.ac.tz Language: English Language: Kiswahili Publication details: Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] c2014Description: 50 Pages; Includes References and AppendicesSubject(s): Summary: Abstract:
Background: Streptococcus pneumonia is a known cause of severe invasive bacterial infection leading to morbidity and mortality among children in sub-Saharan Africa. Nasopharyngeal colonization of S. pneumonia is a critical step towards invasive progression. This study was done to determine the prevalence of nasopharyngeal carriage of S. pneumonia and possible factors associated with the carriage. In addition the susceptibility pattern of isolates to commonly used antibiotics was investigated.
Methods: A total of 350 under-fives attending RCH clinics in Mwanza city were enrolled and investigated for nasopharyngeal carriage of S. pneumonia. Demographic and clinical data were collected using standardized data collection tool. Nasopharyngeal swabs were taken and processed as per standard laboratory procedures. S. pneumonia isolates were identified using conventional methods. Antimicrobial susceptibility testing was performed using the disc diffusion method as described by clinical laboratory standard institute (CLSI)
Results: Of 350 children; 309(88.1%) were under 2years of age while only 11(3.1%) of children were at school. Two hundred and fifty three children (72.3%) had received at least one dose pneumococcal vaccine whereas 83(23.7%) had used antibiotics at median duration of 5 days in the past 14 days. Out of 350 under-fives, 43(12.3%) were found to carry S. pneumonia in their Nasopharynx. Children with chronic diseases and those at school were 3.4 and 4.4 times more risk to be carries of S. pneumonia than their counterpart group (OR; 3.4; 95% CI [1.0-11.6]; p-value 0.05) and (OR; 4.4; 95% CI [1.2-15.7] p-value 0.023) respectively. Number of children at home, positive HIV status and someone smoking showed association with S. pneumonia carriage but the differences were not statistically significant. The resistance levels of S. pneumonia to penicillin, co-trimoxazole and erythromycin were 40%, 88.2% and 41.7% respectively however all of the S. pneumonia isolates were found to be 100% sensitive to ciprofloxacin.
Conclusion: A high nasopharyngeal carriage of penicillin resistant S. pneumoniae is observed in Mwanza, Tanzania despite a good coverage of pneumococcal vaccination. The carriage if significantly associated with schooling, symptoms of upper respiratory tract infections and presence of chronic diseases. Continuous surveillance of penicillin resistant strains coupled with serotyping of the isolates is highly recommended to determine the influence of the pneumococcal vaccination.
| Item type | Current library | Collection | Status | Barcode | |
|---|---|---|---|---|---|
| POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | NFIC | 1 | CREC/412023 |
Abstract:
Background: Streptococcus pneumonia is a known cause of severe invasive bacterial infection leading to morbidity and mortality among children in sub-Saharan Africa. Nasopharyngeal colonization of S. pneumonia is a critical step towards invasive progression. This study was done to determine the prevalence of nasopharyngeal carriage of S. pneumonia and possible factors associated with the carriage. In addition the susceptibility pattern of isolates to commonly used antibiotics was investigated.
Methods: A total of 350 under-fives attending RCH clinics in Mwanza city were enrolled and investigated for nasopharyngeal carriage of S. pneumonia. Demographic and clinical data were collected using standardized data collection tool. Nasopharyngeal swabs were taken and processed as per standard laboratory procedures. S. pneumonia isolates were identified using conventional methods. Antimicrobial susceptibility testing was performed using the disc diffusion method as described by clinical laboratory standard institute (CLSI)
Results: Of 350 children; 309(88.1%) were under 2years of age while only 11(3.1%) of children were at school. Two hundred and fifty three children (72.3%) had received at least one dose pneumococcal vaccine whereas 83(23.7%) had used antibiotics at median duration of 5 days in the past 14 days. Out of 350 under-fives, 43(12.3%) were found to carry S. pneumonia in their Nasopharynx. Children with chronic diseases and those at school were 3.4 and 4.4 times more risk to be carries of S. pneumonia than their counterpart group (OR; 3.4; 95% CI [1.0-11.6]; p-value 0.05) and (OR; 4.4; 95% CI [1.2-15.7] p-value 0.023) respectively. Number of children at home, positive HIV status and someone smoking showed association with S. pneumonia carriage but the differences were not statistically significant. The resistance levels of S. pneumonia to penicillin, co-trimoxazole and erythromycin were 40%, 88.2% and 41.7% respectively however all of the S. pneumonia isolates were found to be 100% sensitive to ciprofloxacin.
Conclusion: A high nasopharyngeal carriage of penicillin resistant S. pneumoniae is observed in Mwanza, Tanzania despite a good coverage of pneumococcal vaccination. The carriage if significantly associated with schooling, symptoms of upper respiratory tract infections and presence of chronic diseases. Continuous surveillance of penicillin resistant strains coupled with serotyping of the isolates is highly recommended to determine the influence of the pneumococcal vaccination.
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