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Updated: Oct 25, 2025
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Urban and Rural Disparities in Pneumococcal Carriage and Resistance in Jordanian Children, 2015-2019
Adnan Al-Lahham1, Nashat Khanfar2, Noor Albataina1
1Department of Biomedical Engineering, School of Applied Medical Sciences, German Jordanian University, Amman 11180, Jordan.
Insights
Pneumococcal carriage and antibiotic resistance were higher in rural Jordanian children compared to urban children. Rural areas showed lower pneumococcal conjugate vaccine (PCV) coverage, highlighting the need for vaccination programs.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Public health
Background:
- A 2015-2019 surveillance study investigated pneumococcal carriage in Jordanian children.
- The study focused on comparing urban (Amman) and rural (eastern Madaba) populations.
Purpose of the Study:
- To determine urban-rural disparities in pneumococcal carriage rates.
- To analyze differences in pneumococcal serotypes and antibiotic resistance.
- To assess the coverage of pneumococcal conjugate vaccines (PCVs) in the studied regions.
Main Methods:
- Nasopharyngeal swabs were collected from 682 children aged 1 to 163 months.
- Standard methods were used for pneumococcal identification, serotyping, and antimicrobial susceptibility testing.
- Data on vaccination status and coverage were collected and analyzed.
Main Results:
- Rural eastern Madaba had a higher pneumococcal carriage rate (39.5%) than urban Amman (31.1%).
- Higher resistance rates to penicillin, clarithromycin, clindamycin, and trimethoprim-sulfamethoxazole were observed in rural areas.
- Predominant serotypes included 19F, 23F, and 14 in both regions, with varying prevalence.
- PCV13 and PCV20 coverage was notably higher in rural eastern Madaba compared to urban Amman.
Conclusions:
- Significant urban-rural differences exist in pneumococcal carriage, resistance patterns, and vaccine coverage in Jordan.
- The findings underscore the critical need for targeted pneumococcal conjugate vaccine (PCV) programs in rural Jordanian communities.
- Addressing these disparities is essential for reducing the burden of pneumococcal disease in children.
Background:
A pneumococcal carriage surveillance study took place examining Jordanian children in urban and rural areas in the period 2015-2019.
Objectives:
To determine urban and rural differences in pneumococcal carriage rate, resistance, and serotypes among healthy Jordanian children from Amman (urban) and eastern Madaba (rural).
Methods:
Nasopharyngeal swabs (NP) were taken from 682 children aged 1 to 163 months. Pneumococcal identification, serotyping, and resistance were performed according to standard method.
Results:
The number of cases tested for Amman was 267 and there were 415 cases tested for eastern Madaba. Carriage rate for eastern Madaba was 39.5% and 31.1% for Amman. Predominant serotypes for eastern Madaba and Amman were 19F (21.3%; 15.7%), 23F (12.2%; 9.6%), 14 (6.7%; 2.4%), 19A (4.9%; 2.4%), and 6A (5.5%; 3.6%). Resistance rates for eastern Madaba and Amman were as follows: penicillin (95.8%; 81.9%), clarithromycin (68.9%; 59.0%), clindamycin (40.8%; 31.3%), and trimethoprim-sulfamethoxazole (73.2%; 61.4%). Coverage of PCV7, PCV13, and the future PCV20 for Amman was 42.2%, 48.2%, and 60.2%; for eastern Madaba, coverage was 50.0%, 62.2%, and 73.2%, respectively. In Amman 25.8% of children received 1-3 PCV7 injections compared to 1.9% of children in eastern Madaba.
Conclusions:
There were significant differences in carriage, resistance, and coverage between both regions. The potential inclusion of a PCV vaccination program for rural areas is essential.
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