Factors affecting streptococcal colonization among children in selected areas of Alaska

The epidemiology of streptococcal disease affecting 706 Alaskan Eskimo children was investigated by analysis of data on throat cultures obtained during a long-term surveillance program begun in 1971. A binary variable multiple-regression model was used to study the association between streptococcal colonization of these children and six potential risk factors: age, sex, number of children in household, region, health-aide rating, and colonization rate for each child the previous year. Factors found to be significantly associated with streptococcal colonization included age, past colonization, competence of local health-aide in providing care, and health-care region. Age varied most in the standardized colonization ratio (percentage of corresponding adjusted rate to overall crude colonization rate), ranging from 122 percent for children 3--6 years old to 67 percent for children 13--18 years old. The number of children in over-crowded homes and a child's sex were not apparently important. The method of analysis can be used to provide health-care planners with a simple means of identifying potentially important areas of concern for planning effective and economical health-care strategy.