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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Nasopharyngeal carriage of Streptococcus pneumoniae: Prevalence and risk factors in HIV-positive children in Tanzania
International Journal of Infectious Diseases, Volume 16, No. 10, Year 2012
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Description
Background: Pneumococcal colonization of the nasopharynx is especially common in young children and is a pre-requisite for pneumococcal disease. Those with immunosuppression, such as HIV, are at higher risk of colonization and disease, especially at older ages. Currently, vaccination schedules are only offered to children under 6 months of age, despite the large impact of pneumococcal disease in older unvaccinated children with HIV. We conducted a study to assess the prevalence of, and risk factors for, pneumococcal carriage in HIV-positive children aged <15 years. Methods: We collected a single nasopharyngeal swab from 142 HIV-infected children aged 1-14 years over a 2-month period. To detect carriage of pneumococcus, these samples were cultured and serotyped; PCR was performed on negative samples. We also collected epidemiological data via survey and medical records. Results: The overall carriage rate was 81% and was at least 76% in those aged 5-14 years. The 7-, 10-, and 13-valent pneumococcal vaccines would cover 37%, 37%, and 49% of children with carriage, respectively. In the multivariate analysis, we identified increase in weight since last visit (p= 0.028) and the existence of care-givers who had respiratory symptoms in the past week (p= 0.022) as risk factors for carriage. Weight gain was also significantly associated with antiretroviral use (p= 0.002). Conclusions: These data illuminate the little known area of pneumococcal carriage in older HIV-infected children as well as finding novel risk factors for pneumococcal carriage, namely the association with household members who have respiratory symptoms and with an increase in the child's weight prior to swabbing. Weight gain may be due to an increase in health enabling more mobility and increasing the risk of acquiring carriage. The carriage rate observed (81%) is one of the highest recorded. Further research should address whether vaccination can prevent the acquisition of carriage and so protect against disease. © 2012 International Society for Infectious Diseases.
Authors & Co-Authors
Anthony, Laura
Unknown Affiliation
Meehan, Andrea
Unknown Affiliation
Amos, Ben
Unknown Affiliation
Mtove, George A.
Unknown Affiliation
Mjema, Julius
Unknown Affiliation
Malahiyo, Rajabu
Unknown Affiliation
Yin, J. Kevin
Unknown Affiliation
Oftadeh, Shahin
Unknown Affiliation
Gilbert, Gwendolyn L.
Unknown Affiliation
Shingadia, Delane V.
Unknown Affiliation
Reyburn, Hugh G.
Unknown Affiliation
Deen, Jacqueline L.
Unknown Affiliation
Richmond, Peter
Unknown Affiliation
Booy, Robert
Unknown Affiliation
Statistics
Citations: 24
Authors: 14
Affiliations: 12
Identifiers
Doi:
10.1016/j.ijid.2012.05.1037
ISSN:
12019712
e-ISSN:
18783511
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Tanzania