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Pneumococcal carriage among HIV infected children in Accra, Ghana
Eric S Donkor1, Jennifer A Annan2, Ebenezer V Badoe3
1Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana. ericsdon@hotmail.com.
Insights
Pneumococcal carriage affects over a quarter of HIV-infected children in Ghana, with respiratory symptoms being a key risk factor. Non-vaccine serotypes and multiple serotype carriage were common, impacting vaccine effectiveness.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology of Streptococcus pneumoniae
- HIV/AIDS Research
Background:
- Pneumococcal carriage is a precursor to pneumococcal disease and transmission.
- Limited data exists on pneumococcal carriage in HIV-infected individuals in Africa.
- Understanding carriage is crucial for disease prevention and control.
Purpose of the Study:
- To investigate the epidemiology of pneumococcal carriage among HIV-infected children in Ghana.
- To determine carriage prevalence, associated risk factors, and serotype distribution.
- To assess the potential impact on vaccine strategies.
Main Methods:
- Cross-sectional study conducted at a tertiary hospital in Accra, Ghana.
- Recruitment of 118 HIV-infected children, with nasopharyngeal swabs collected.
- Culture and serotyping of Streptococcus pneumoniae isolates; epidemiological data collected.
Main Results:
- Pneumococcal carriage prevalence was 27.1% among HIV-infected children.
- Respiratory symptoms were significantly associated with carriage (OR, 2.63; p=0.034).
- Serotype 19F was most prevalent; 13-valent Pneumococcal Conjugate Vaccine coverage was 41.5%.
Conclusions:
- Pneumococcal carriage is prevalent in this pediatric HIV population.
- Non-vaccine serotypes and multiple serotype carriage were common.
- Respiratory symptoms are a significant determinant of pneumococcal carriage.
Background:
Pneumococcal carriage is the precursor for development of pneumococcal disease, and is also responsible for transmission of the organism from person-to-person. In Africa, little is known about the pneumococcus in relation to people with HIV infection. The aim of the study was to investigate the epidemiology of pneumococcal carriage among HIV infected children visiting a tertiary hospital in Ghana, including the carriage prevalence, risk factors and serotype distribution.
Method:
This was a cross sectional study carried out from February to May, 2015 at the HIV Paediatric Clinic of the Korle-Bu Teaching Hospital in Accra, Ghana. One hundred and eighteen HIV infected children were recruited and nasopharyngeal (NP) swabs were collected from them. Epidemiological data on demographic, household and clinical features of the study participants were also collected. The NP specimens were cultured for Streptococcus pneumoniae and the isolates were serotyped by latex agglutination. The data of the study was analysed using STATA 11 (Strata Corp, College Station, TX, USA).
Results:
Prevalence of pneumococcal carriage among the HIV infected children was 27.1% (95% CI: 19.1 to 35.1) and the only factor significantly associated with pneumococcal carriage was the presence of respiratory symptoms (OR, 2.63; CI, 1.06-6.53; p = 0.034). The most prevalent pneumococcal serotype among the study participants was serotype 19F (24.4%), followed by 16F (22%). Serotype coverage of the 13-valent Pneumococcal Conjugate Vaccine in this study was 41.5%. Multiple carriage of pneumococcal serotypes among the positive carriage cases was 34.3%.
Conclusion:
Pneumococcal carriage occurred in more than a quarter of the study population and was characterized by predominance of non-vaccine serotypes as well as a high prevalence of multiple carriage. Presence of respiratory symptoms appears to be a major determinant of pneumococcal carriage among the study population.