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Prevalence of Group A beta‐haemolytic Streptococcus isolated from children with acute pharyngotonsillitis in Aden, Yemen
Author(s) -
BaSaddik I. A.,
Munibari A. A.,
Alhilali A. M.,
Ismail S. M.,
Murshed F. M.,
Coulter J. B. S.,
Cuevas L. E.,
Hart C. A.,
Brabin B. J.,
Parry C. M.
Publication year - 2014
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/tmi.12264
Subject(s) - pharyngitis , medicine , group a , streptococcus , tonsillitis , throat culture , acute tonsillitis , rheumatic fever , streptococcus pyogenes , throat , genotype , group b , pediatrics , immunology , staphylococcus aureus , surgery , biology , bacteria , biochemistry , genetics , gene
Objectives To estimate the prevalence of Group A beta‐haemolytic streptococcus ( GAS ) and non‐ GAS infections among children with acute pharyngotonsillitis in Aden, Yemen, to evaluate the value of a rapid diagnostic test and the McIsaac score for patient management in this setting and to determine the occurrence of emm genotypes among a subset of GAS isolated from children with acute pharyngotonsillitis and a history of acute rheumatic fever ( ARF ) or rheumatic heart disease ( RHD ). Methods Group A beta‐haemolytic streptococcus infections in school‐aged children with acute pharyngotonsillitis in Aden, Yemen, were diagnosed by a rapid GAS antigen detection test ( RADT ) and/or GAS culture from a throat swab. The RADT value and the McIsaac screening score for patient management were evaluated. The emm genotype of a subset of GAS isolates was determined. Results Group A beta‐haemolytic streptococcus pharyngotonsillitis was diagnosed in 287/691 (41.5%; 95% CI 37.8–45.3) children. Group B, Group C and Group G beta‐haemolytic streptococci were isolated from 4.3% children. The RADT had a sensitivity of 238/258 (92.2%) and specificity of 404/423 (95.5%) against GAS culture. A McIsaac score of ≥4 had a sensitivity of 93% and a specificity of 82% for confirmed GAS infection. The emm genotypes in 21 GAS isolates from children with pharyngitis and a history of ARF and confirmed RHD were emm 87 (11), emm 12 (6), emm 28 (3) and emm 5 (1). Conclusion This study demonstrates a very high prevalence of GAS infections in Yemeni children and the value of the RADT and the McIsaac score in this setting. More extensive emm genotyping is necessary to understand the local epidemiology of circulating strains.