Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T21:47:32.011Z Has data issue: false hasContentIssue false

A one-year study of streptococcal infections and their complications among Ethiopian children

Published online by Cambridge University Press:  15 May 2009

W. Tewodros*
Affiliation:
Department of Biology, and Child Health, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
L. Muhe
Affiliation:
Department of Pediatrics and Child Health, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
E. Daniel
Affiliation:
Department of Pediatrics and Child Health, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
C. Schalén
Affiliation:
Department of Medical Microbiology, Lund University, Sölvegatan 23, S-223 62, Lund, Sweden
G. Kronvall
Affiliation:
Department of Clinical Microbiology, Karolinska Institute and Hospital, P.O. Box 60500, S-104 01, Stockholm, Sweden
*
*W. Tewodros. Department of Clinical Microbiology, Karolinska Institute and Hospital, P.O. Box 60500, S-104 01, Stockholm, Sweden
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Post-streptococcal complications are known to be common among Ethiopian children. Little is known, however, about the epidemiology of beta-haemolytic streptococci in Ethiopia. A total of 816 children were studied during a one-year period: 24 cases of acute rheumatic fever (ARF), 44 chronic rheumatic heart disease (CRHD), 44 acute post streptococcal glomerulonephritis (APSGN), 143 tonsillitis, 55 impetigo, and 506 were apparently healthy children. Both ARF and APSGN occurred throughout the year with two peaks during the rainy and cold seasons. The female: male ratio among ARF patients was 1·4:1 and 1:1·9 among APSGN. The monthly carrier rate of beta-haemolytic streptococci group A varied from 7·5–39%, average being 17%. T type 2 was the most frequent serotype. Marked seasonal fluctuations were noted in the distribution of serogroups among apparently healthy children. Beta-haemolytic streptococci group A dominated during the hot and humid months of February–May. Strains were susceptible to commonly used antibiotics, except for tetracycline.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

References

REFERENCES

1.Veasy, GL, Wiedmeier, SE, Orsmond, GS, et al. Resurgence of acute rheumatic fever in the intermountain area of the United States. N Eng J Med 1987; 316: 421–6.CrossRefGoogle ScholarPubMed
2.Wald, ER, Dashefsky, B, Feidt, C, Chiponis, D, Byers, C. Acute rheumatic fever in western Pennsylvania and the tristate area. Pediatrics 1987; 80: 371–4.CrossRefGoogle ScholarPubMed
3.Kaplan, EL, Johnston, DR, Cleary, PP. Group A streptococcal serotypes isolated from patients and sibling contacts during the resurgence of rheumatic fever in the United States in the mid-1980's. J Infect Dis 1989; 159: 101–2.CrossRefGoogle Scholar
4.Stollerman, GH. Rheumatogenic group A streptococci and the return of rheumatic fever. Adv Intern Med 1990; 35: 126.Google Scholar
5.Martin, PR, Høiby, EA. Streptococcal serogroup A epidemic in Norway, 1987–1988. Scand J Infect Dis 1988; 22: 421–9.CrossRefGoogle Scholar
6.Ispahani, P, Donald, FE, Aveline, AJD. Streptococcus pyogenes: an old enemy subdued but not defeated. J Infect 1988; 16: 3746.CrossRefGoogle Scholar
7.Strömberg, A, Romanus, V, Burman, L. Outbreak of group A streptococcal bacteremia in Sweden: An epidemiologic and clinical study. J Infect Dis 1991; 164: 595–8.CrossRefGoogle Scholar
8.El Kholy, A, Sorour, AH, Houser, HB, et al. A three year prospective study of streptococcal infections in a population of rural Egyptian schoolchildren. J Med Microbiol 1973; 6: 101–10.CrossRefGoogle Scholar
9.Valkenburg, HA, Muller, AS, Wolters, CHL, Steenhuis, EM. Streptococci in Liberia and Nigeria. West Africa. In: Haverkorn, MJ, ed. Streptococcal disease and the community. New York: Excerpta Medical American Elsevier Co. Inc., 1974: 209–14.Google Scholar
10.Ogunbi, O, Lasi, Q, Lawal, SF. An epidemiological study of beta-hemolytic streptococcal infections in a Nigerian (Lagos) urban population. In: Haverkorn, MJ, ed. Streptococcal disease and the community. New York: Excerpta Medical American Elsevier Co. Inc., 1974: 282–6.Google Scholar
11.Lawal, SF, Odugbemi, T, Coker, AO, Solanke, EO. Persistent occurrence of beta-hemolytic streptococci in population of Lagos school children. J Trop Med Hyg 1990; 93: 417–8.Google ScholarPubMed
12.Halim, AM, Jacques, JK. Rheumatic heart disease in the Sudan. Br Heart J 1961; 23: 383–8.CrossRefGoogle ScholarPubMed
13.Ey, J, Johnson, C. Management of cardiac disease in a paediatric cardiology clinic. Ethiop Med J 1974; 12: 125–30.Google Scholar
14.Hadgu, P, Parry, EHO. Ethiopian cardiovascular studies. V. Cardiac disease in children. Ethiop Med J 1968; 6: 135–40.Google Scholar
15.D'arbela, PG, Patel, AK, Somers, K. Rheumatic fever and rheumatic heart disease at Mulago Hospital. Kampala. Uganda: some aspects of the pattern of the disease. East Afr Med J 1974; 51: 710–13.Google ScholarPubMed
16.Ogunbi, O, Fadahunsi, HO, Ahmed, I, et al. An epidemiological study of rheumatic fever and rheumatic heart disease in Lagos. J Epidemiol Commun Hlth 1978; 32: 6871.CrossRefGoogle ScholarPubMed
17.Sawsan, HM, El Tayeb, HMS, Wannamaker, LW, Nasr, EMM, El Salaam, EA. Clinical and laboratory observations on overt acute glomerulonephritis (APSGN) in Cairo. In; Parker, MT, ed. Pathogenic streptococci. Proceedings of the VIIth International Symposium on Streptococci and Streptococcal Disease. Chertsey, England: Reedbooks Ltd. 1979: 131–3.Google Scholar
18.Abegaz, B. Pattern of cardiac diseases in an Ethiopian children's hospital. Ethiop Med J 1988; 26: 16.Google Scholar
19.Axemo, P, Freij, L, Hadgu, P, et al. Streptococcal types in impetigo and acute glomerulonephritis among children in Addis Ababa. Scand J Infect Dis 1976; 8: 161–4.CrossRefGoogle ScholarPubMed
20.Committee on standards and criteria for programs of care of the council of rheumatic fever and congenital heart disease of the American Heart Association, 1965. Jones criteria (revised) for guidance in the diagnosis of rheumatic fever. Circulation 1965; 32: 664–9.CrossRefGoogle Scholar
21.Johnson, DR, Kaplan, EL. Microtechnique for serum opacity factor characterization of group A streptococci adaptable to the use of human sera. J Clin Microbiol 1988; 26: 2025–30.CrossRefGoogle Scholar
22.Swedish Reference Group for Antibiotics. Antimicrobial susceptibility testing of bacteria. National Bacteriological Laboratory, Stockholm. 1990.Google Scholar
23.Glover, JA. Milroy lectures on the incidence of rheumatic disease. The incidence of acute rheumatism. Lancet 1930; i: 499505.Google Scholar
24.Quinn, RW. Comprehensive review of morbidity and mortality trends for rheumatic fever, streptococcal disease, and scarlet fever: The decline of rheumatic fever. Rev Infect Dis 1989; 2: 928–53.CrossRefGoogle Scholar
25.Somwang, D, Sankaburanuraksa, S, Prutsachatvuthi, S, Leetarasmme, A, Trakulosomboon, S, Shokerchareonratana, S. The beta-hemolytic streptococcal pharyngeal carriers in school children. Med Assoc Thailand 1989; 71: 561–5.Google Scholar
26.Hill, HR, Wilson, E, Caldwell, GG, Hager, D, Zimmerman, RA. Epidemic of pharyngitis due to streptococci of Lancefield group G. Lancet 1969; ii: 371–4.CrossRefGoogle Scholar
27.Benjamin, J, Perriello, VA. Pharyngitis due to group C hemolytic streptococci in children. J Pediatr 1976; 89: 254–5.CrossRefGoogle Scholar
28.McCue, JD. Group G streptococcal pharyngitis: analysis of an outbreak at a college. JAMA 1982; 248: 1333–6.CrossRefGoogle Scholar
29.Schwartz, RH, Shulman, T. Group C and group G streptococci. Tn office isolation from children and adolescents with pharyngitis. Clin Pediatr 1986: 25: 496502.CrossRefGoogle Scholar
30.Cimolai, N, Elford, RW, Bryan, L, Arnald, C, Perger, P. Do non-group A streptococci cause endemic pharyngitis. Rev Infect Dis 1988; 10: 587601.CrossRefGoogle Scholar
31.Hayden, GF, Murphy, TF, Hendley, JO. Non group A streptococci in the pharynx: pathogens or innocent. Am J Dis Child 1989; 143: 794–7.CrossRefGoogle ScholarPubMed
32.Cimoli, N, MacCulloch, L, Damm, S. The epidemiology of beta-hemolytic non-group g streptococci isolated from the throats of children over a one vear period. Epidemiol Infect 1990; 104: 119–26.CrossRefGoogle Scholar
33.Gerber, MA, Randolph, MF, Martin, NJ, et al. Community wide outbreak of group G streptococcal pharyngitis. Pediatrics 1991; 87: 598603.CrossRefGoogle ScholarPubMed
34.Meier, FA, Centor, RM, Graham, L, Dalton, HP. Clinical and microbiological evidence for endemic pharyngitis among adults due to group C streptococci. Arch Intern Med 1990; 150: 825–9.CrossRefGoogle ScholarPubMed
35.Tuner, JC, Hayden, GF, Kiselica, D, Lohr, J, Eishburne, CF, Murren, D. Association of group C beta-hemolytic streptococci with endemic pharyngitis among college students. JAMA 1990; 264: 2644–7.Google Scholar
36.Ferguson, GW, Shultz, JM, Bisno, AL. Epidemiology of acute rheumatic fever in a multiethnic, multiracial urban community: The Miami-Dade county experience. J Infect Dis 1991; 164: 720–5.CrossRefGoogle Scholar
37.Maekawa, S, Fukuda, K, Yamauehi, T, Yamaguchi, T, Takahashi, K, Sugawa, K. Follow-up study of pharyngeal carriers of beta-hemolytic streptococci among school children in Sapporo city during a period of 2 years and 5 months. J Clin Microbiol 1981: 13: 1007–22.CrossRefGoogle Scholar
38.Hoffmann, S. The throat carrier rate of group A and other beta-hemolytic streptococci among patients in general practice. Acta Path Microbiol Immunol Scand Sect B 1985; 93: 347–51.Google Scholar
39.Martin, DR. Streptococcal infections. Rheumatogenic streptococci reconsidered. New Zealand Med J 1988; 101: 394–6.Google ScholarPubMed
40.Taplin, D, Lansdell, L, Allen, A, Rodriguez, R, Cortes, A. Prevalence of streptococcal pyoderma in relation to climate and hygiene. Lancet 1973: i: 501–3.CrossRefGoogle Scholar
41.Potter, EV, Svartman, M, Burt, EG, Finklea, JF, Poon-King, T, Earle, DP. Relationship of acute rheumatic fever to acute glomerulonephritis in Trinidad. J Infect Dis 1972; 125: 619–25.CrossRefGoogle ScholarPubMed
42.Potter, EV, Svartman, M, Mohammed, I, Cox, R, Poon-King, T, Earle, DP. Tropical acute rheumatic fever and associated streptococcal infections compared with concurrent acute glomerulonephritis. J Pediatr 1978; 92: 325–33.CrossRefGoogle ScholarPubMed
43.Jelinkovà, J, Rotta, J, Duben, J. Long term study of the prevalence of different groups of streptococci. In: Haverkorn, MJ, ed. Streptococcal disease and the community. New York: Excerpta Medical American Elsevier Co. Inc., 1972: 198203.Google Scholar
44.Maruyama, S, Yoshioka, H, Fuiita, K, Takimoto, M, Satake, Y. Sensitivity of group A streptococci to antibiotics. Am J Dis Child 1979; 133: 1143–5.CrossRefGoogle Scholar
45.Holmström, L, Nyman, B, Rosengren, M, Wallander, S, Ripa, T. Outbreaks of infections with erythromycin-resistant group A streptococci in child day care centers. Scand J Infect Dis 1990: 22: 179–85.CrossRefGoogle Scholar
46.Seppälä, H, Nissinen, A, Järvinen, H, et al. Resistance to erythromycin in group A streptococci. New Eng J Med 1992; 326: 292–7.CrossRefGoogle ScholarPubMed
47.Forsgren, A, Walder, M. Haemophilus influenzae, pneumococci, group A streptococci and Staphylococcus aureus: Sensitivity of outpatient strains to commonly prescribed antibiotics. Scand J Infect Dis 1982; 14: 3941.CrossRefGoogle Scholar
48.Railings, I, Bengtsson, S, Christensen, P, Holm, SE, Lind, L, Kalin, M. Antibiotic sensitivity of Haemophilus influenzae. Streptococcus pneumoniae. Streptococcus pyogenes, and Branhamella catarrhalis isolated from upper respiratory tract infection in Sweden. Scand J Infect Uis 1983; 39 (Suppl): 100–5.Google Scholar
49.Gedebou, M, Tassew, A, Azene, G. Frequency and resistance patterns of bacterial isolates from surgical patients in teaching hospital in Addis Ababa. Trop Geograph Med 1983; 35: 133–8.Google ScholarPubMed
50.Tewodros, W, Gedebou, M. Nasal carrier rates and antibiotic resistance of Staphylococcus aureus isolates from hospital and non-hospital populations, Addis Ababa. Trans Roy Soc Trop Med Hyg 1984; 78: 314–18.CrossRefGoogle ScholarPubMed
51.Strömberg, A, Schwan, A, Cars, O. Bacteriological and serological aspects of group A streptococcal pharvngotonsillitis caused by group A streptococci. Euro J Clin Microbiol Infect Dis 1988; 7: 172–4.CrossRefGoogle Scholar
52.Sanders, E. Bacterial interference. I. Its occurrence among the respiratory tract flora and characterization of inhibition of group A streptococci by viridans streptococci. J Infect Dis 1969; 120: 698707.CrossRefGoogle Scholar
53.Holm, SE, Grahn, E. Bacterial interference in streptococcal tonsillitis. Scand J Infect Dis. Supp. 1983; 39: 73–8.Google ScholarPubMed
54.Grahn, E, Holm, SE. Bacterial interference in the thorax flora during a streptococcal tonsillitis outbreak in an apartment house area. Zbl Bakt Hyg A 1983; 256: 72–9.Google Scholar
55.Tagg, JR, Dajani, AS, Wannamaker, LW, Gray, ED. Group A streptococcal bacteriocin; production, purification and mode of action. J Exp Med 1973; 138: 1168–83.CrossRefGoogle Scholar
56.Bisno, AL, Pearce, IA, Wall, HP, Moody, MD, Stollerman, GH. Contrasting epidemiology of acute rheumatic fever and acute glomerulonephritis. Nature of the antecedent streptococcal infection. N Eng J Med 1970; 283: 561–5.CrossRefGoogle Scholar