title: Throat carriage rate and antimicrobial susceptibility pattern of group A Streptococci (GAS) in healthy Ethiopian school children.
abstract: BACKGROUND
  Group A Streptococci (GAS) or Streptococcus pyogenes are the most frequent cause of pharyngitis and skin infection in children and lead to post infection complications including acute rheumatic fever and glomerulonephritis. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. There is not much information on the screening of children for carriage of GAS in Ethiopia.
  
  
  OBJECTIVE
  The study aimed at assessing the carriage rate of Group A Streptococci and antimicrobial susceptibility of the isolates in healthy Ethiopian school children.
  
  
  METHODS
  A total of 937 children residing in Addis Ababa (n=491), Gondar (n=265) and Dire-Dawa (n=181) were investigated during a period between November 2004 and January 2005. Throat specimens were collected and cultured using standard procedure. Beta haemolytic streptococci were serogrouped by agglutination tests using specific antisera. Antimicrobial susceptibility testing of the isolates was performed by diffusion method.
  
  
  RESULTS
  The median and the mean ages of the study participants were 11 (range 6-14) years. Girls constituted 52% (486/937) of the study participants. A total of 167 (17.8%) beta haemolytic streptococci were recovered from 937 children investigated GAS accounted for 91/167 (54.5%) of beta hemolytic streptococcal isolates. The carrier rate for GAS was 9.7% (91/937) of the screened children followed by group G with 3.2% (30/937) and group C streptococci with 2.2% (21/937). All GAS isolates were sensitive to oxacillin, penicillin, erythromycin, clindamycin and trimethoprim-sulphamethoxazole. Lower frequency of resistance was observed against tetracycline and vanocmycin.
  
  
  CONCLUSIONS
  The present study revealed that GAS was the most predominant beta-haemolytic streptococcus among healthy Ethiopian school children. Our results showed that pharyngeal carriage of GAS in school children should not be underestimated. Therefore it is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimize GAS resistance.
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Alemseged
authors.initials: A
authors.lastname: Abdissa
authors.forename: Daniel
authors.initials: D
authors.lastname: Asrat
authors.forename: Göran
authors.initials: G
authors.lastname: Kronvall
authors.forename: Belay
authors.initials: B
authors.lastname: Shitu
authors.forename: Dilachew
authors.initials: D
authors.lastname: Achiko
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zeidan
authors.forename: Lawrence K
authors.initials: LK
authors.lastname: Yamuah
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000208:ethnology* / Q000382:microbiology; D002648:Child; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010614:Pharynx / Q000382:microbiology*; D012574:Schools; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000890:Anti-Infective Agents