Epidemiology of pneumococcal carriage in children under fi ve years of age in Accra, Ghana
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Infectious Diseases
Abstract
Background: Although the majority of pneumococcal infections occur in the developing world, pneumococcal epidemiology
is poorly understood in these settings. The aim of the study was to investigate the epidemiology of pneumococcal carriage
among children younger than 5 years at a paediatric healthcare centre in Ghana. Method: Four-hundred and twenty-three
children were randomly sampled and nasopharyngeal specimens were collected from them. The specimens were cultured
for Streptococcus pneumoniae, and the isolates were subjected to antibiotic susceptibility testing and serotyping by latex
agglutination. Epidemiological data on demographic and clinical features of the study subjects were collected. Results:
The prevalence of pneumococcal carriage was 48.9% (207/422), with age groups 43 – 48 months having the highest car riage prevalence. In the multivariate analysis, pneumococcal carriage was signifi cantly associated with runny nose (odds
ratio 1.9, p 0.003) and day-care attendance (odds ratio 1.5, p 0.04). No pneumococcal resistance was observed
for ceftriaxone, while the prevalence of resistance to the other antibiotics tested was: cotrimoxazole 100%, ampicillin
88%, tetracycline 78%, penicillin 63% and erythromycin 24%. Fourteen different pneumococcal serogroups/serotypes
were identifi ed and serogroup 6 was the most prevalent (30%), followed by serotype 19 (20%). Conclusions: We conclude
that pneumococcal carriage among the study children is high and the carried strains have a high level of resistance
( 50%) to several antibiotics. Ceftriaxone is a suitable antibiotic for treating pneumococcal infections in Ghana, and
the use of this antibiotic coupled with the pneumococcal vaccination is expected to signifi cantly reduce the burden of
pneumococcal disease in the country.
Description
Research Article
Keywords
Antibiotic resistance, Ghana, Pneumococcus, serotype, vaccine