title: Nasopharyngeal carriage of respiratory pathogens in Warao Amerindians: significant relationship with stunting.
abstract: To assess risk factors for nasopharyngeal carriage of potential pathogens in geographically isolated Warao Amerindians in Venezuela.
  
  
  
  In this point prevalence survey, nasopharyngeal swabs were obtained from 1064 Warao Amerindians: 504 children aged 0-4 years, 227 children aged 5-10 years and 333 caregivers. Written questionnaires were completed to obtain information on demographics and environmental risk factors. Anthropometric measurements were performed in children aged 0-4 years.
  
  
  
  Carriage rates of Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis were 51%, 7%, 1% and 13%, respectively. Crowding index, method of cooking and tobacco exposure were not associated with increased carriage. In multivariable analysis, an increase in height-for-age Z score (i.e. improved chronic nutritional status) was associated with decreased odds of S. pneumoniae colonisation (OR 0.76, 95% CI 0.70-0.83) in children aged 0-4 years.
  
  
  
  Better knowledge of demographic and environmental risk factors facilitates better understanding of the dynamics of colonisation with respiratory bacteria in an Amerindian population. Poor chronic nutritional status was associated with increased pathogen carriage in children <5 years of age. The high rates of stunting generally observed in indigenous children may fuel the acquisition of respiratory bacteria that can lead to respiratory and invasive disease.
authors.affiliation: Laboratorio de Tuberculosis, Universidad Central de Venezuela, Caracas, Venezuela.|Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.|Wilhelmina Children's Hospital Utrecht, Utrecht, The Netherlands.
authors.forename: Lilly M
authors.initials: LM
authors.lastname: Verhagen
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Meyke
authors.initials: M
authors.lastname: Hermsen
authors.affiliation: Laboratorio de Tuberculosis, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: Ismar A
authors.initials: IA
authors.lastname: Rivera-Olivero
authors.affiliation: Laboratorio de Tuberculosis, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: María Carolina
authors.initials: MC
authors.lastname: Sisco
authors.affiliation: Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marien I
authors.initials: MI
authors.lastname: de Jonge
authors.affiliation: Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Peter W M
authors.initials: PW
authors.lastname: Hermans
authors.affiliation: Laboratorio de Tuberculosis, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: Jacobus H
authors.initials: JH
authors.lastname: de Waard
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D005260:Female; D006090:Gram-Negative Bacteria / Q000254:growth & development*; D006130:Growth Disorders / Q000150:complications*; D006801:Humans; D007199:Indians, South American; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology*; D009752:Nutritional Status; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000209:etiology* / Q000382:microbiology; D012307:Risk Factors; D013210:Staphylococcus / Q000254:growth & development*; D011795:Surveys and Questionnaires; D014687:Venezuela; D055815:Young Adult
keywords: chronic malnutrition; colonisation nasopharyngée; colonización nasofaríngea; desnutrición crónica; facteurs de risque; factores de riesgo; indigenous people; malnutrition chronique; nasopharyngeal colonisation; pathogènes respiratoires; patógenos respiratorios; personas indígenas; peuples autochtones; respiratory pathogens; risk factors