title: β-Hemolytic streptococcal throat carriage and tonsillopharyngitis: a cross-sectional prevalence study in Gabon, Central Africa.
abstract: BACKGROUND
  Group A streptococcus (GAS) and possibly other β-hemolytic streptococci (BHS) account for a considerable morbidity and mortality burden in African populations; however, disproportionately little is known about the epidemiology of BHS in sub-Saharan Africa. This study assessed the prevalence of GAS, group G streptococcus (GGS) and group C streptococcus (GCS) carriage and tonsillopharyngitis in a Central African population.
  
  
  METHODS
  A prospective cross-sectional study was performed to assess the prevalence of and risk factors for BHS carrier status and tonsillopharyngitis in children and adults in Gabon.
  
  
  RESULTS
  The overall BHS carrier prevalence was 135/1,005 (13.4%); carrier prevalence of GAS, GGS, and GCS was 58/1,005 (5.8%), 50/1,005 (5.0%), and 32/1,005 (3.2%), respectively. Streptococcal carriage was associated with school and pre-school age (adjusted OR 2.65, 95% CI 1.62-4.36, p = 0.0001 and 1.90, 95% CI 1.14-3.17, p = 0.0141, respectively). Participants residing in urban areas were less likely carriers (OR 0.52, p = 0.0001). The point-prevalence of BHS-positive tonsillopharyngitis was 1.0% (9/1,014) and 15.0% (6/40) in school children with sore throat.
  
  
  CONCLUSIONS
  Non-GAS exceeded GAS throat carriage and tonsillopharyngitis suggesting a yet underestimated role of non-GAS streptococci in BHS diseases.
authors.affiliation: Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon, sabine.belard@charite.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Bélard
authors.forename: Nicole
authors.initials: N
authors.lastname: Toepfner
authors.forename: Benjamin
authors.initials: B
authors.lastname: Arnold
authors.forename: Abraham Sunday
authors.initials: AS
authors.lastname: Alabi
authors.forename: Reinhard
authors.initials: R
authors.lastname: Berner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010612:Pharyngitis / Q000453:epidemiology* / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology*; D015995:Prevalence; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013291:Streptococcus / Q000145:classification; D013297:Streptococcus pyogenes / Q000145:classification*; D055815:Young Adult