A study of group a streptococcal pharyngitis among 3–15-year-old children attending clinics for an acute sore throat
Chinyere Chikodili Uzodimma1, Florence Iyabode Dedeke2, Victor Nwadike3, Olasunkanmi Owolabi4, Gregory Arifalo5, Omolara Oduwole6
1 Department of Pediatrics, Paediatric Cardiology Unit, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
2 Department of Paediatrics, Neonatology Unit, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
3 Department of Microbiology, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
4 Department of Paediatrics, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
5 Department of Family Medicine, Sacred Heart Hospital, Abeokuta, Ogun State, Nigeria
6 Department of Pediatrics, General Hospital, Abeokuta, Ogun State, Nigeria
Chinyere Chikodili Uzodimma
Department of Pediatrics, Paediatric Cardiology Unit, Federal Medical Centre, Idi-Aba, Abeokuta, Ogun State
Source of Support: None, Conflict of Interest: None
Background: Group A beta-hemolytic Streptococcus (GABHS) is the only causative organism of pharyngitis that is linked to the etiopathogenesis of acute rheumatic fever and rheumatic heart disease.
Aim and Objectives: The objectives of the study were to determine the proportion of GABHS-related pharyngitis, the relationship of clinical symptoms and signs with positive culture outcome, and the antibiotic sensitivity pattern of GABHS among children aged 3–15 years, presenting with symptoms of sore throat in three public hospital settings across Abeokuta.
Methods: Consecutive children aged 3–15 years who present with sore throat or drooling of saliva and any one of these following signs and symptoms were considered eligible: fever >37.5C, cervical lymphadenopathy, inflamed tonsils, and exudative tonsils. All bacitracin susceptible Gram-positive, catalase-negative cocci were classified as Streptococcus pyogenes.
Results: Of 3386 children that were seen, (30) children met the eligibility criteria. Sixteen (53.3%) were males while 14 (46.7%) were females. The mean age of the children was 7.37 years ± 3.146. Cough was the most sensitive symptom (65%) while the presence of exudate was the most specific sign (70%) for GABHS acute sore throat. GABHS was isolated in 66.7% of the children. Streptococcus viridans was found in 4 (13.3%) while the remaining 6 (20%) were sterile. The highest sensitivity was shown to gentamicin and chloramphenicol while amoxicillin-clavulanic acid had the highest resistance (94%).
Conclusion: The proportion of GABHS throat infection is high in this environment. The current findings underscore the need to increase awareness about appropriate throat examination and treatment of sore throat among primary care physicians.