ASSOCIATION OF ACUTE SORE THROAT WITH GROUP A BETA HEAMOLYTIC STREPTOCOCCI CARRIAGE AMONG CHILDRED IN A PUBLIC SCHOOL IN CALABAR-IMPLICATIONS FOR THE CONTROL OF RHEUMATIC FEVER/RHEUMATIC HEART DISEASE (RH/RHD) IN DEVELOPING COUNTRIES

Abstract

Two Hundred and Seventeen (217) throat swabs were obtained from apparently healthy children aged 4-13 years attending a public primary school in Calabar, South Eastern Nigeria. The swabs were transported in Staurts transport medium to the Microbiology Laboratory of the University of Calabar Teaching Hospital, Calabar Nigeria and examined bacteriologically using 7% sheep blood agar incubated in 5% carbondioxide environment at 37oC for 48 hours. Seventy one (32.7%) were found positive for Group A beta-haemolytic streptococci (GABHS). Children aged 4-5 years had the highest carriage rate, (45.0%). Carriage rate decreased with age but did not vary significantly with sex. The rate of detection of GABHS was highest among children with current sore throat, (76.9%). Relative risk ratio associating GABHS with acute sore throat was 7.2 (95% C.I, 2.23-0.71). This high odds ratio provides a strong positive predictive index for the diagnosis of GABHS in cases of acute sore throat. These findings further re-enforce the view that the target group for primary prevention of RF/RHD is young school-aged children. We suggest that all cases of acute sore throat in children be treated for GABHS. Control efforts should include improvement in overall living standards, nutrition and integration of primary preventive strategies for RF/RHD into Primary Health Care (PHC) / School Heath programmes.


Key Words: Streptococcal throat carriage among Nigerian children.


(Global J Med Sci: 2002 1(1): 55-59)