ABSTRACT
Data on the prevalence of pneumococcal nasopharyngeal carriage and its risk factors among adolescents are scarce. The aim of this study was to provide such information. A cross-sectional, population-based prospective study was conducted. Participants were 1013 adolescents (age range 10-19 years) randomly recruited in 22 public schools. Those schools were randomly chosen among 307 public schools from 11 Sanitary Districts of Salvador, Brazil. Nasopharyngeal samples were assessed by standard procedures to recover and identify Streptococcus pneumoniae. Data on potential risk factors were gathered by confidential interview based on a standardized questionnaire. Pneumococci were recovered from 8.2 % [83/1013, 95 % confidence interval (CI) 6.6-10.0]. By stepwise logistic regression, pneumococcal colonization was independently associated with younger age [odds ratio (OR) 0.85, 95 % CI 0.77-0.94, P=0.001], being male (OR 1.78, 95 % CI 1.11-2.85, P=0.02), exposure to passive smoke in the household (OR 1.76, 95 % CI 1.10-2.79, P=0.02), having an upper respiratory infection during recruitment (OR 2.67, 95 % CI 1.67-4.28, P<0.001) and having a history involving an episode of acute asthma during the last year (OR 2.89, 95 % CI 1.18-7.08, P=0.03). The estimated probability of pneumococcal colonization decreased with age (chi(2) for trend=8.52, P=0.003). These findings provide tools for increasing the use of prevention strategies for pneumococcal diseases, such as pneumococcal vaccination among asthmatic patients and public health measures to stop smoking.
Subject(s)
Carrier State/epidemiology , Pneumococcal Infections/epidemiology , Respiratory Tract Infections/epidemiology , Streptococcus pneumoniae/isolation & purification , Adolescent , Age Factors , Brazil/epidemiology , Carrier State/microbiology , Child , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Pharynx/microbiology , Pneumococcal Infections/microbiology , Prevalence , Prospective Studies , Respiratory Tract Infections/microbiology , Risk Factors , Sex Factors , Surveys and Questionnaires , Tobacco Smoke PollutionABSTRACT
Surveillance of nasopharyngeal pneumococcus has proven to be a valuable tool for the monitoring of antibiotic resistance. We reviewed the latest information on colonization rate and penicillin resistance by making a MEDLINE search, using the terms "nasopharyngeal carriage" and "Streptococcus pneumoniae". Out of 225 articles found, data from 109 recent publications (89 percent from 1996-2003) were analyzed. Data were reported from 41 countries of six continents. Individuals under the age of five (64.3 percent) or 10 years (85.7 percent) were enrolled, including children attending day-care centers (32.1 percent) or orphanages (3.6 percent), and healthy individuals (78.6 percent) or sick patients (43.6 percent); biological samples were collected mainly by nasopharyngeal swabs (89.3 percent). The highest colonization rates were reported from Africa (85-87.2 percent), where several authors did not find high rates of penicillin resistance. On the other hand, studies conducted in North and Central America reported high-level penicillin resistance at rates of approximately 20-30 percent. Great variation in the rates of pneumococcal colonization and penicillin resistance were observed within regions or continents. There were also considerable differences in similar populations located in different areas of the same country. Data regarding pneumococcal colonization and penicillin resistance are not available from most countries. We also examined the use of antibiotics to treat pneumococcal infections.
Subject(s)
Child , Child, Preschool , Humans , Anti-Bacterial Agents/pharmacology , Carrier State/epidemiology , Nasopharynx/microbiology , Penicillin Resistance , Streptococcus pneumoniae/isolation & purification , Carrier State/microbiology , Global Health , Microbial Sensitivity Tests , Streptococcus pneumoniae/drug effectsABSTRACT
Surveillance of nasopharyngeal pneumococcus has proven to be a valuable tool for the monitoring of antibiotic resistance. We reviewed the latest information on colonization rate and penicillin resistance by making a MEDLINE search, using the terms "nasopharyngeal carriage" and "Streptococcus pneumoniae". Out of 225 articles found, data from 109 recent publications (89% from 1996-2003) were analyzed. Data were reported from 41 countries of six continents. Individuals under the age of five (64.3%) or 10 years (85.7%) were enrolled, including children attending day-care centers (32.1%) or orphanages (3.6%), and healthy individuals (78.6%) or sick patients (43.6%); biological samples were collected mainly by nasopharyngeal swabs (89.3%). The highest colonization rates were reported from Africa (85-87.2%), where several authors did not find high rates of penicillin resistance. On the other hand, studies conducted in North and Central America reported high-level penicillin resistance at rates of approximately 20-30%. Great variation in the rates of pneumococcal colonization and penicillin resistance were observed within regions or continents. There were also considerable differences in similar populations located in different areas of the same country. Data regarding pneumococcal colonization and penicillin resistance are not available from most countries. We also examined the use of antibiotics to treat pneumococcal infections.
Subject(s)
Anti-Bacterial Agents/pharmacology , Carrier State/epidemiology , Nasopharynx/microbiology , Penicillin Resistance , Streptococcus pneumoniae/isolation & purification , Carrier State/microbiology , Child , Child, Preschool , Global Health , Humans , Microbial Sensitivity Tests , Streptococcus pneumoniae/drug effectsABSTRACT
Na adolescência, novas manifestações de caráter biológico, psicológico e social são expressas. Neste período, os jovens estão aptos para a reprodução, entretanto, ainda estão por se desenvolver as habilidades emocionais e de apoio social. Neste estudo, buscou-se descrever características do comportamento sexual de adolescentes do gênero feminino e a freqüência de educação sexual em dois grupos socialmente distintos. Métodos: Este é um estudo transversal, realizado em Salvador, em 1994, no qual foram avaliadas 1.507 escolares com idade entre 10 e 20 anos. A seleção das escolas abrangeu dois estratos sociais, sendo 10 públicas e 7 particulares, que foram selecionadas por meio de um desenho estratificado e uma tabela de números aleatórios. Empregou-se um questionário fechado com 45 questões sobre fonte educacional, conhecimento e comportamento das jovens, relacionado às atividades sexuais e suas conseqüências. Após uma explanação de um mesmo entrevistador, as questões foram preenchidas em sala de aula. Resultados: A média da idade em que ocorreu a primeira relação sexual foi de 15 anos e 9 meses. Em ambos os grupos escolares houve registro destas iniciativas entre 10-12 anos. As adolescentes das escolas públicas usaram menos método anticoncepcional (32,1 por cento vs 69,2 por cento) e engravidaram mais (10,8 por cento vs 3,9 por cento). Ter recebido educação sexual foi referido por 86,6 por cento e 73,0 por cento das jovens das escolas particulares ou públicas, sendo que a educação foi considerada insuficiente por 55,3 por cento e 62,2 por cento, respectivamente. Conclusão: É necessário não só ensinar, mas educar nossos jovens em todas as escolas. É possível que jovens mais satisfeitas com a educação sexual recebida possam exercer suas atividades sexuais com segurança e prazer.
