ABSTRACT
Background: Group A streptococcal ß-hemolytic (GAS) is an important cause of morbidity and mortality among children and responsible for 20 30% of bacterial pharyngitis. Rare to few published data on the pattern of GAS epidemiology in Mozambique exists. Objective: To Characterize the epidemiology of GAS infection in patients with signs and symptoms of pharyngitis at the Polana Canico Health Center (PCHC) in Maputo. Methods: A cross sectional study was conducted on 81 children aged 5-15 years with pharyngitis who attended the PCHC from July to September, 2014. Demographic and clinical data were collected through a standardized questionnaire. Throat swabs were collected and processed with standard microbiological techniques to isolate GAS. The data analysis was performed using Epi Info 7 statistical software. Results: Females accounted for 55,6 % of children with symptoms of pharyngitis. Fifty five point six percent of the children were 5 - 9 years old, 83.9% lived less than 10 km from the Health facility. Most children lived in a household with more than 6 people (55.5) %, and 9,8% in houses constructed with non conventional materials . Children care givers had only primary education (54.3%), no formal occupation (77.7%) and a monthly income below the minimum wage (56.7%) The most common signs and symptoms were sore throat (86.4%), fever (50.6%) and redsess of the mucosa palate (16.0%). On physical examination, 30.8% had inflammation of the tonsils and 32.1% of them had palpable and painful cervical lymphadenopaties. Eighty one swab samples were processed, five (6.1%) were positive for GAS in children aged between 10-15 years (60%), female (60%) and most lived in households with less than 6 people (60%). All the children with positive GAS had sore throat. Conclusions: Streptococcus pyogenes was detected among patients assisted at the PCHC with symptoms of pharyngitis mainly affecting female, early teenaged children. Children with GAS infection presented sore throats, fever and tonsillar hypertrophy. Considering the high prevalence of rheumatic heart disease in the Mozambican population, it is urgent to define protocols for diagnosis and treatment. Treatment should focus on the use of empirical antibiotic therapy through identification of specific clinical signs and symptoms since laboratory tests are not widely available.
Subject(s)
Humans , Child , Patients , Population , Respiratory Tract Infections , Streptococcus pyogenes , Pharyngitis , Health Centers , Diagnosis , Infections , Anti-Bacterial Agents , Signs and Symptoms , Family Characteristics , Epidemiology , Microbiological Techniques , Hemolytic Agents , FeverABSTRACT
Background: Group A streptococcal ß-hemolytic (GAS) is an important cause of morbidity and mortality among children and responsible for 20 30% of bacterial pharyngitis. Rare to few published data on the pattern of GAS epidemiology in Mozambique exists. Objective: To Characterize the epidemiology of GAS infection in patients with signs and symptoms of pharyngitis at the Polana Canico Health Center (PCHC) in Maputo. Methods: A cross sectional study was conducted on 81 children aged 5-15 years with pharyngitis who attended the PCHC from July to September, 2014. Demographic and clinical data were collected through a standardized questionnaire. Throat swabs were collected and processed with standard microbiological techniques to isolate GAS. The data analysis was performed using Epi Info 7 statistical software. Results: Females accounted for 55,6 % of children with symptoms of pharyngitis. Fifty five point six percent of the children were 5 -9 years old,83.9% lived less than 10 km from the Health facility. Most children lived in a house hold with more than 6 people (55.5) %, and 9,8% in houses constructed with non-conventional materials .Children care givers had only primary education (54.3%), no formal occupation(77.7%) and a monthly income below the minimum wage (56.7%) The most common signs and symptoms were sore throat (86.4%), fever (50.6%) and redress of the mucosa palate (16.0%).On physical examination, 30.8% had inflammation of the tonsils and 32.1% of them had palpable and painfulcervicallymphadenopaties. Eighty one swab samples were processed, five (6.1%) were positive for GAS in children aged between 10-15 years (60%), female (60%) and most lived in households with less than 6 people (60%). All the children with positive GAS had sore throat. Conclusions: Streptococcus pyogeneswas detected among patients assisted at the PCHC with symptoms of pharyngitis mainly affecting female, early teenaged children. Children with GAS infection presented sore throats, fever and tonsillar hypertrophy. Considering the high prevalence of rheumatic heart disease in the Mozambican population, it is urgent to define protocols for diagnosis and treatment. Treatment should focus on the use of empirical antibiotic therapy through identification of specific clinical signs and symptoms since laboratory tests are not widely available.
