Asymptomatic carriage of pneumococcus in children under 2 years of age in Libreville: prevalence and associated factors

Steeve Mintoo; Chimene Nze-Nkoghe; Fifi C. Loembe; Patrice Makouloutou-Nzatsi; Boris Makanga; Diane Ditsoga-Kombila; Simon J. Ategbo

doi:10.18203/2349-3291.ijcp20240083

Authors

Steeve Mintoo Department of Pediatrics, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon https://orcid.org/0000-0002-9529-4915
Chimene Nze-Nkoghe Institut de Recherche en Ecologie Tropicale (IRET) (Research Institute in Tropical Ecology), CENAREST, Libreville, Gabon
Fifi C. Loembe Department of Pediatrics, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
Patrice Makouloutou-Nzatsi Institut de Recherche en Ecologie Tropicale (IRET) (Research Institute in Tropical Ecology), CENAREST, Libreville, Gabon
Boris Makanga Institut de Recherche en Ecologie Tropicale (IRET) (Research Institute in Tropical Ecology), CENAREST, Libreville, Gabon
Diane Ditsoga-Kombila Department of Pediatrics, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
Simon J. Ategbo Department of Pediatrics, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon

DOI:

https://doi.org/10.18203/2349-3291.ijcp20240083

Keywords:

Streptococcus pneumoniae, Asymptomatic carriage, Prevalence, Infants, Libreville, Associated factors

Abstract

Background: The morbidity and mortality attributed to pneumococcus are impressive even in the absence of any problem of antibiotic resistance. The objectives of this study were to determine the prevalence of asymptomatic pneumococcal carriage in children aged between 2 months and 2 years in Libreville and to identify the socio-demographic factors associated with carriage.

Methods: Cross-sectional, descriptive, and analytical study from September 2019 to February 2020, including infants aged 2 months to 2 years, randomly selected, in 8 health centres in Libreville. We collected sociodemographic data from children and parents. Nasopharyngeal swabs were taken from each child and analyzed in the laboratory of institut de recherche en ecologie tropicale (IRET). Categorical data were expressed as frequencies. Univariate analyses (odd ratio-OR) were performed to measure the relationship between the relevant variables and pneumococcal carriage, followed by a multivariate analysis using logistic regression. The threshold of statistical significance was set at p<0.05 for a two-tailed chi-square test.

Results: Of the 434 children included, 51.2% (n=222) were girls, with a mean age of 5.4±3.2 months. Streptococcus pneumoniae was found in 53 children, giving a prevalence of 12.6% (95% CI [9.5-15.6%]). The prevalence was the same for both sexes. Carriage was associated with more than 2 siblings (OR=2.1; p=0.01); an age greater than 6 months (OR=3.6; p=0.001); a child's rank higher than the median (OR=2.3; p=0.006); a mother's low level of education (OR=4.5; p=0.001); a father working in the informal sector (OR=2.4; p=0.01). The mother's level of education was the factor found in the multivariate analysis (p=0.043).

Conclusions: The data from this survey encourage the serotyping of strains to guide the vaccination strategy.

Metrics

Metrics Loading ...

References

World Health Organization (WHO). World Pneumonia Day 2019. Available at: https://stoppneumonia.org/le-12-novembre-journée-internationale-de-la-pneumonie/. Accessed on 12 December, 2023.

Abaye G, Fekadu H, Haji K, Alemu D, Anjulo AA, Yadates DT. Prevalence and risk factors of pneumococcal nasopharyngeal carriage in healthy children attending kindergarten, in the district of Arsi Zone, South East, Ethiopia. BMC Res Notes. 2019;12:253.

Pariente N, On behalf of the PLOS Biology Staff Editors. The antimicrobial resistance crisis needs action now. PLoS Biol. 2022;20(11):e3001918.

El-Beleidy A, El-Saied M, Fasseeh N, Rehab ZElS, Hammam H. A Systematic Review of Pneumococcal Carriage, Disease, Antimicrobial Resistance, and Vaccination in Egyptian Children Aged 18 Years and Younger. Infect Dis Ther. 2021;10:2119-55.

Beletew B, Bimerew M, Mengesha A, Wudu M, Azmeraw M. Prevalence of pneumonia and its associated factors among under-five children in East Africa: a systematic review and meta-analysis. BMC Pediatr. 2020;20(1):254.

Abdullahi O, Karani A, Tigoi CC, Daisy M, Stella K, Eva W et al. The prevalence and risk factors for pneumococcal colonization of the nasopharynx among children in Kilifi District, Kenya. PLoS One. 2012;7(2):1-8.

Narwortey DK, Owusu-ofori A, Slotved H, Eric SD, Patrick OA, Paul W et al. Nasopharyngeal carriage of Streptococcus pneumoniae among healthy children in Kassena-Nankana districts of Northern Ghana. BMC Infect Dis. 2021;21(1):661.

Schaumburg F, Alabi A, Eiff VC, Arnaud F, Hafsatou T, Martin PG et al. Streptococcus pneumoniae colonization in remote African pygmies. Trans R Soc Trop Med Hyg. 2013;107(2):105-9.

Kremsner PG, Grobusch MP. Carriage of encapsulated bacteria in Gabonese children with sickle cell anemia. Clin Microbiol Infect. 2012;19(3):235-41.

Direction Générale de la Statistique (DGS). Third Demographic and Health Survey 2019-2021, 2023. Gabon-Third Demographic and Health Survey 2019-2021 (worldbank.org). 2023.

Hill PC, Cheung YB, Akisanya A, Kawsu S, George L, Brian MG et al. Nasopharyngeal Carriage of Streptococcus pneumoniae in Gambian Infants: A Longitudinal Study. Clin Infect Dis. 2008;46(6):807-14.

Courtois F, Péneau S, Salanave B, Valentina AA, Marie FR-C, Mathilde T et al. Trends in breastfeeding practices and mothers' experience in the French NutriNet-Santé cohort. Int Breastfeed J. 2021;16(1):50.

Abateneh DD, Shano AK, Dedo TW, Leila CC, Marcelo C, Maria DGSC et al. Nasopharyngeal Carriage of Streptococcus pneumoniae and Associated Factors among Children in Southwest Ethiopia Abstract: Open Microbiol J. 2020;14(6):171-8.