Donkor Eric S, Annan Jennifer A, Badoe Ebenezer V, Dayie Nicholas T K D, Labi Appiah-Korang, Slotved Hans-Christian
Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana.
Department of Child Health, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
BMC Infect Dis. 2017 Feb 8;17(1):133. doi: 10.1186/s12879-017-2224-0.
Pneumococcal carriage is the precursor for development of pneumococcal disease, and is also responsible for transmission of the organism from person-to-person. In Africa, little is known about the pneumococcus in relation to people with HIV infection. The aim of the study was to investigate the epidemiology of pneumococcal carriage among HIV infected children visiting a tertiary hospital in Ghana, including the carriage prevalence, risk factors and serotype distribution.
This was a cross sectional study carried out from February to May, 2015 at the HIV Paediatric Clinic of the Korle-Bu Teaching Hospital in Accra, Ghana. One hundred and eighteen HIV infected children were recruited and nasopharyngeal (NP) swabs were collected from them. Epidemiological data on demographic, household and clinical features of the study participants were also collected. The NP specimens were cultured for Streptococcus pneumoniae and the isolates were serotyped by latex agglutination. The data of the study was analysed using STATA 11 (Strata Corp, College Station, TX, USA).
Prevalence of pneumococcal carriage among the HIV infected children was 27.1% (95% CI: 19.1 to 35.1) and the only factor significantly associated with pneumococcal carriage was the presence of respiratory symptoms (OR, 2.63; CI, 1.06-6.53; p = 0.034). The most prevalent pneumococcal serotype among the study participants was serotype 19F (24.4%), followed by 16F (22%). Serotype coverage of the 13-valent Pneumococcal Conjugate Vaccine in this study was 41.5%. Multiple carriage of pneumococcal serotypes among the positive carriage cases was 34.3%.
Pneumococcal carriage occurred in more than a quarter of the study population and was characterized by predominance of non-vaccine serotypes as well as a high prevalence of multiple carriage. Presence of respiratory symptoms appears to be a major determinant of pneumococcal carriage among the study population.
肺炎球菌携带是肺炎球菌疾病发生的先兆，也是该病菌在人与人之间传播的原因。在非洲，关于艾滋病毒感染者体内的肺炎球菌情况知之甚少。本研究的目的是调查在加纳一家三级医院就诊的艾滋病毒感染儿童中肺炎球菌携带的流行病学情况，包括携带率、危险因素和血清型分布。
这是一项于2015年2月至5月在加纳阿克拉科勒布教学医院的艾滋病毒儿科诊所开展的横断面研究。招募了118名艾滋病毒感染儿童，并采集了他们的鼻咽拭子。还收集了研究参与者的人口统计学、家庭和临床特征等流行病学数据。对鼻咽标本进行肺炎链球菌培养，并通过乳胶凝集法对分离株进行血清分型。使用STATA 11（美国德克萨斯州大学站斯特拉塔公司）对研究数据进行分析。
艾滋病毒感染儿童中肺炎球菌携带率为27.1%（95%置信区间：19.1%至35.1%），与肺炎球菌携带显著相关的唯一因素是呼吸道症状的存在（比值比，2.63；置信区间，1.06 - 6.53；p = 0.034）。研究参与者中最常见的肺炎球菌血清型是19F型（24.4%），其次是16F型（22%）。本研究中13价肺炎球菌结合疫苗的血清型覆盖率为41.5%。阳性携带病例中肺炎球菌血清型多重携带率为34.3%。
超过四分之一的研究人群存在肺炎球菌携带情况，其特征是非疫苗血清型占主导以及多重携带率较高。呼吸道症状的存在似乎是研究人群中肺炎球菌携带的主要决定因素。
