Prevalence and predicting factors of Group A beta-hemolytic Streptococcus carrier state in primary schoolchildren

Area of Science:

• Microbiology
• Epidemiology
• Public Health

Background:

• Group A Streptococcus (GAS) transmission from asymptomatic children poses a risk for acute rheumatic fever.
• Understanding the prevalence and predictors of GAS carriage in children is crucial for public health interventions.

Purpose of the Study:

• To determine the prevalence and predictors of the GAS carrier state in asymptomatic schoolchildren in Jakarta, Indonesia.
• To evaluate the antibiotic susceptibility patterns of GAS isolates.

Main Methods:

• A stratified random sample of 201 asymptomatic schoolchildren (aged 6-12) was recruited.
• Participants underwent physical examination and laboratory tests, including throat swab cultures for GAS.
• Multivariate analysis was used to identify predictors of GAS carriage.

Main Results:

• The prevalence of GAS carrier state was 13.9% (95% CI: 9.2%-18.6%).
• Tonsillar enlargement was the only significant predictor of GAS carriage (P=0.03).
• GAS isolates showed 100% sensitivity to penicillin G, 89% to erythromycin, and decreasing sensitivity to tetracycline (32%).

Conclusions:

• The GAS carrier state is prevalent in school-aged children, with tonsillar enlargement being a key predictive factor.
• Penicillin G remains a highly effective treatment, while increasing resistance to tetracycline necessitates monitoring.
• These findings highlight the importance of identifying GAS carriers in school settings to prevent rheumatic fever.