title: Invasive Group A Streptococcus Infection among Children, Rural Kenya.
abstract: To determine the extent of group A Streptococcus (GAS) infections in sub-Saharan Africa and the serotypes that cause disease, we analyzed surveillance data for 64,741 hospital admissions in Kilifi, Kenya, during 1998-2011. We evaluated incidence, clinical presentations, and emm types that cause invasive GAS infection. We detected 370 cases; of the 369 for which we had data, most were skin and soft tissue infections (70%), severe pneumonia (23%), and primary bacteremia (14%). Overall case-fatality risk was 12%. Incidence of invasive GAS infection was 0.6 cases/1,000 live births among neonates, 101/100,000 person-years among children <1 year of age, and 35/100,000 among children <5 years of age. Genome sequencing identified 88 emm types. GAS causes serious disease in children in rural Kenya, especially neonates, and the causative organisms have considerable genotypic diversity. Benefit from the most advanced GAS type-specific vaccines may be limited, and efforts must be directed to protect against disease in regions of high incidence.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Seale
authors.forename: Mark R
authors.initials: MR
authors.lastname: Davies
authors.forename: Kirimi
authors.initials: K
authors.lastname: Anampiu
authors.forename: Susan C
authors.initials: SC
authors.lastname: Morpeth
authors.forename: Sammy
authors.initials: S
authors.lastname: Nyongesa
authors.forename: Salim
authors.initials: S
authors.lastname: Mwarumba
authors.forename: Pierre R
authors.initials: PR
authors.lastname: Smeesters
authors.forename: Androulla
authors.initials: A
authors.lastname: Efstratiou
authors.forename: Rosylene
authors.initials: R
authors.lastname: Karugutu
authors.forename: Neema
authors.initials: N
authors.lastname: Mturi
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Williams
authors.forename: J Anthony G
authors.initials: JA
authors.lastname: Scott
authors.forename: Samuel
authors.initials: S
authors.lastname: Kariuki
authors.forename: Gordon
authors.initials: G
authors.lastname: Dougan
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008875:Middle Aged; D009026:Mortality; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D011159:Population Surveillance; D012307:Risk Factors; D012424:Rural Population; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality / Q000517:prevention & control; D022541:Streptococcal Vaccines / Q000276:immunology; D013297:Streptococcus pyogenes / Q000145:classification / Q000235:genetics*; D055815:Young Adult
chemical_list: D022541:Streptococcal Vaccines
keywords: GAS; Kenya; Streptococcus pyogenes; bacteria; child; children; group A Streptococcus; infection; neonatal
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