Risk factors associated with Streptococcus pneumonia carriage in children under five years old with acute respiratory infection in Niger

Abstract

Introduction: streptococcus pneumonia is a leading cause of bacterial pneumonia, meningitis and sepsis in children, and pneumococcal carriage is
an important source of horizontal spread of these pathogens within the community. Methods: a questionnaire was addressed to parents for the
collection of sociodemographic and medical information. Nasopharyngeal swabbing was processed using a molecular method. We used logistic
regression models to examine independent associations between pneumococcal carriage and potential risk factors. All associations with a p-value of
< 0.25 in the bivariate regression analyses were subsequently entered in the multivariate regression model. Results: a total of 637 children aged 1
to 59 months admitted for acute respiratory infection were included. The rate of respiratory virus carriage was 76%, whereas that of bacteria was
47% and that of bacteria-virus co-colonization was 42%. A bivariate analysis showed that carriage was not related to gender, father's or mother's
education level, father's occupation, type of housing or lighting, or passive exposure to cigarette smoking in the house. It was also not linked to
complete vaccination with PCV-13 or PPSV-23 and antibiotic treatment prior to hospitalization. A multivariate analysis showed that carriage was
related to age greater than 3 months, maternal occupation, house flooring type, and co-colonization of another bacterium and virus.
Conclusion: these results can be helpful to understand the dynamics of pneumococcal nasopharyngeal colonization; they confirm the interest of
vaccinating infants before the age of 3 months with appropriate vaccine to prevent spread nasopharyngeal colonization and pneumococcal diseases
in children.