Eyo-Ita Emmanuel U, Sadoh Wilson E, Abiodun Philip O, Eyo-Ita Ifueko A
Department of Child Health, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria.
College of Medical Sciences, University of Benin, PMB 1154, Benin City, Nigeria.
Int J Cardiol Cardiovasc Risk Prev. 2024 Mar 25;21:200256. doi: 10.1016/j.ijcrp.2024.200256. eCollection 2024 Jun.
The prevention and treatment of Rheumatic Heart disease is hinged on antibiotic administration in children with Group A (GAS) pharyngitis and Acute Rheumatic Fever (ARF). The Upper Limit of Normal (ULN) for serum Anti-streptolysin O titre (ASOT) has been employed as proof of antecedent GAS pharyngitis to fulfil the Jones' criteria for diagnosis of ARF. This value has not been generated among West African children. Generalization of values from Caucasians (200 IU/ml) is likely to result in over-diagnosis, owing to higher GAS pharyngitis incidence in Africa. We aimed to determine the serum ASOT and its ULN in apparently healthy school-aged children in Egor Local Government Area (LGA), south-south Nigeria and to determine their relationship with socio-demographic characteristics. We recruited 384 apparently healthy school-aged pupils across eleven schools. Serum ASOT was determined by turbidimetry. Statistical analysis was done using student's t-test and Analysis of Variance (ANOVA). Level of significance was set at p < 0.05. The mean age was 8.53 ± 1.97(range 6-12) years and male-female ratio was 1.1:1. The ULN and geometric mean serum ASOT were 390.76 IU/ml and 230.04 ± 1.86 IU/ml respectively. No significant correlation was found between serum ASOT and age (r-value of -4.8%). The ULN did not vary significantly with gender, socio-economic class and the presence/absence of over-crowding in homes. The ULN for serum ASOT in apparently healthy school-aged children in Egor LGA is higher than the currently used international value. Clinicians in West Africa should consider applying higher cut-off values for the diagnosis of ARF.
风湿性心脏病的防治取决于对A组（A群链球菌）咽炎和急性风湿热（ARF）患儿使用抗生素。血清抗链球菌溶血素O滴度（ASOT）的正常上限（ULN）已被用作先前A群链球菌咽炎的证据，以满足ARF诊断的琼斯标准。西非儿童中尚未得出该数值。将高加索人的数值（200 IU/ml）推广应用可能会导致过度诊断，因为非洲的A群链球菌咽炎发病率较高。我们旨在确定尼日利亚西南部埃戈尔地方政府辖区（LGA）表面健康的学龄儿童的血清ASOT及其ULN，并确定它们与社会人口学特征的关系。我们在11所学校招募了384名表面健康的学龄学生。通过比浊法测定血清ASOT。使用学生t检验和方差分析（ANOVA）进行统计分析。显著性水平设定为p < 0.05。平均年龄为8.53 ± 1.97岁（范围6 - 12岁），男女比例为1.1:1。ULN和血清ASOT几何平均值分别为390.76 IU/ml和230.04 ± 1.86 IU/ml。未发现血清ASOT与年龄之间存在显著相关性（r值为 -4.8%）。ULN在性别、社会经济阶层以及家庭是否拥挤方面无显著差异。埃戈尔LGA表面健康的学龄儿童血清ASOT的ULN高于目前使用的国际数值。西非临床医生在诊断ARF时应考虑应用更高的临界值。
