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Portadores nasofaríngeos de S. pneumoniae entre niños pequeños de Nepal rural
Author(s) -
Coles Christian L.,
Sherchand Jeevan B.,
Khatry Subarna K.,
Katz Joanne,
LeClerq Steven C.,
Mullany Luke C.,
Tielsch James M.
Publication year - 2009
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2009.02331.x
Subject(s) - carriage , medicine , streptococcus pneumoniae , penicillin , erythromycin , odds ratio , pneumonia , population , serotype , epidemiology , pediatrics , antibiotics , immunology , microbiology and biotechnology , environmental health , biology , pathology
Summary Objectives To provide epidemiologic data on Streptococcus pneumoniae ( Spn ) carriage in Nepal. Methods Prospective, population‐based study among children in Sarlahi, Nepal to estimate carriage prevalence, identify risk factors, and determine antibiotic susceptibility patterns and serotype distribution. Between December 2003 and July 2004, NP specimens were collected from 604 children aged 1–36 months with acute lower respiratory infection (ALRI) and 604 healthy, age‐ and season‐matched controls. Results Of the 1100 specimens analysed, carriage prevalence was approximately 80% in both groups. In the multivariate analyses, significant risk factors for Spn carriage in controls were Muslim religion [adjusted odds ratio (AOR): 2.93] and no latrine in the household (AOR: 2.41). Those treated for a recent illness had lower carriage rates (AOR: 0.37). Results were similar for ALRI cases with the addition of age ≥12 months (AOR: 1.68), and symptomatic infection (AOR: 3.78) as risk factors. The antibiotics and proportions of isolates resistant to them were as follows: penicillin 4.5%, cotrimoxazole 89.2%, chloramphenicol 1.4%, erythromycin 1.5% and tetracycline 22.7%. The most prevalent serogroups/types were 6, 19, 23, 15, 9 and 10. Conclusions Young children in rural Nepal experience high rates of Spn carriage. Most isolates were resistant to cotrimoxazole. Current conjugate Spn vaccines may substantially reduce the risk of a severe pneumonia and other Spn infections.