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Risk factors of streptococcal colonization in school age children
S Likitnukul1, N Prapphal, K Tatiyakavee
1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Poor hygiene and infrequent teeth brushing significantly increase Streptococcus colonization in Bangkok schoolchildren. These factors, combined with clinical signs, can help predict streptococcal infections in children.
Area of Science:
- Microbiology
- Public Health
- Pediatrics
Background:
- Streptococcal infections pose a significant health risk in school-aged children.
- Understanding colonization factors is crucial for prevention and control strategies.
- Socioeconomic status can influence exposure to pathogens and hygiene practices.
Purpose of the Study:
- To investigate the prevalence of Beta hemolytic Streptococcus (BHS) and Beta hemolytic Streptococcus group A (BHSA) in school children.
- To identify risk factors associated with Streptococcus colonization in low socioeconomic settings.
- To explore the potential of combining risk factors and clinical manifestations for predicting streptococcal infections.
Main Methods:
- Conducted throat swab cultures on 4,055 school-aged children (6-11 years) from two low socioeconomic schools.
- Administered questionnaires to assess personal hygiene, socioeconomic factors, and clinical manifestations.
- Analyzed data to determine associations between risk factors and Streptococcus colonization.
Main Results:
- Beta hemolytic Streptococcus (BHS) was isolated in 43% and Beta hemolytic Streptococcus group A (BHSA) in 18% of throat cultures.
- Infrequent teeth brushing (once or less daily) was significantly linked to BHS presence.
- Poor personal hygiene (shared glasses, playing in dirty water), poor sanitation, and low income were associated with BHSA presence.
Conclusions:
- Hygiene practices and socioeconomic factors play a critical role in Streptococcus colonization among children.
- Specific risk factors are associated with different types of Beta hemolytic Streptococcus.
- Integrating identified risk factors with clinical symptoms may improve the accuracy of diagnosing streptococcal infections.
Abstract:
We studied the factors influencing the colonization of Streptococcus in school age children aged 6-11 years from 2 low socioeconomic schools of the Bangkok Metropolitan area. 4,055 throat swab cultures were performed. Beta hemolytic Streptococcus (BHS) and beta hemolytic Streptococcus group A (BHSA) were isolated in 1,747 (43%) and 744 (18%) respectively. 1,547 questionnaires were returned from the children. Of these, 750 and 570 were found to have BHS and BHSA in the throat, respectively. Among the risk factors, considered, teeth brushing of one time or none per day was significant for BHS positive in the throat as compared with the BHS negative group, while personal hygiene such as sharing glass with other, playing in dirty water, poor housing sanitation and low family income was significantly associated with the BHSA positive group. With the combination of certain clinical manifestations, these factors may increase the accuracy of predicting streptococcal infection.