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. 1992 Oct;109(2):211–225. doi: 10.1017/s0950268800050172

A one-year study of streptococcal infections and their complications among Ethiopian children.

W Tewodros 1, L Muhe 1, E Daniel 1, C Schalén 1, G Kronvall 1
PMCID: PMC2271921  PMID: 1397112

Abstract

Post-streptococcal complications are known to be common among Ethiopian children. Little is known, however, about the epidemiology of beta-haemolytic streptococci in Ethiopia. A total of 816 children were studied during a one-year period: 24 cases of acute rheumatic fever (ARF), 44 chronic rheumatic heart disease (CRHD), 44 acute post streptococcal glomerulonephritis (APSGN), 143 tonsillitis, 55 impetigo, and 506 were apparently healthy children. Both ARF and APSGN occurred throughout the year with two peaks during the rainy and cold seasons. The female:male ratio among ARF patients was 1.4:1 and 1:1.9 among APSGN. The monthly carrier rate of beta-haemolytic streptococci group A varied from 7.5-39%, average being 17%. T type 2 was the most frequent serotype. Marked seasonal fluctuations were noted in the distribution of serogroups among apparently healthy children. Beta-haemolytic streptococci group A dominated during the hot and humid months of February-May. Strains were susceptible to commonly used antibiotics, except for tetracycline.

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Selected References

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  1. Abegaz B. Pattern of cardiac diseases in an Ethiopian children's hospital. Ethiop Med J. 1988 Jan;26(1):1–7. [PubMed] [Google Scholar]
  2. Axemo P., FREIJ L., Hadgu P., Holm S. E., Islander G., Larsson A., Nilsson L. Streptococcal types in impetigo and acute glomerulonephritis among children in Addis Ababa. Scand J Infect Dis. 1976;8(3):161–164. doi: 10.3109/inf.1976.8.issue-3.07. [DOI] [PubMed] [Google Scholar]
  3. Benjamin J. T., Perriello V. A., Jr Pharyngitis due to group C hemolytic streptococci in children. J Pediatr. 1976 Aug;89(2):254–256. doi: 10.1016/s0022-3476(76)80459-3. [DOI] [PubMed] [Google Scholar]
  4. Bisno A. L., Pearce I. A., Wall H. P., Moody M. D., Stollerman G. H. Contrasting epidemiology of acute rheumatic fever and acute glomerulonephritis. N Engl J Med. 1970 Sep 10;283(11):561–565. doi: 10.1056/NEJM197009102831103. [DOI] [PubMed] [Google Scholar]
  5. Cimolai N., Elford R. W., Bryan L., Anand C., Berger P. Do the beta-hemolytic non-group A streptococci cause pharyngitis? Rev Infect Dis. 1988 May-Jun;10(3):587–601. doi: 10.1093/clinids/10.3.587. [DOI] [PubMed] [Google Scholar]
  6. Cimolai N., MacCulloch L., Damm S. The epidemiology of beta-haemolytic non-group A streptococci isolated from the throats of children over a one-year period. Epidemiol Infect. 1990 Feb;104(1):119–126. doi: 10.1017/s0950268800054595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. D'Arbela P. G., Patel A. K., Somers K. Juvenile rheumatic fever and rheumatic heart disease at Mulago Hospital, Kampala, Uganda: some aspects on the pattern of the disease. East Afr Med J. 1974 Oct;51(10):710–714. [PubMed] [Google Scholar]
  8. Ey J., Johnson C. Management of cardiac disease in a paediatric cardiology clinic. Ethiop Med J. 1974 Jul;12(3):125–130. [PubMed] [Google Scholar]
  9. Ferguson G. W., Shultz J. M., Bisno A. L. Epidemiology of acute rheumatic fever in a multiethnic, multiracial urban community: the Miami-Dade County experience. J Infect Dis. 1991 Oct;164(4):720–725. doi: 10.1093/infdis/164.4.720. [DOI] [PubMed] [Google Scholar]
  10. Forsgren A., Walder M. Haemophilus influenzae, Pneumococci, group A streptococci and Staphylococcus aureus: sensitivity of outpatient strains to commonly prescribed antibiotics. Scand J Infect Dis. 1982;14(1):39–43. doi: 10.3109/inf.1982.14.issue-1.08. [DOI] [PubMed] [Google Scholar]
  11. Gedebou M., Tassew A., Azene G. Frequency and resistance patterns of bacterial isolates from surgical patients in a teaching hospital in Addis Ababa. Trop Geogr Med. 1983 Jun;35(2):133–138. [PubMed] [Google Scholar]
  12. Gerber M. A., Randolph M. F., Martin N. J., Rizkallah M. F., Cleary P. P., Kaplan E. L., Ayoub E. M. Community-wide outbreak of group G streptococcal pharyngitis. Pediatrics. 1991 May;87(5):598–603. [PubMed] [Google Scholar]
  13. HALIM A. M., JACQUES J. E. Rheumatic heart disease in the Sudan. Br Heart J. 1961 Jul;23:383–386. doi: 10.1136/hrt.23.4.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hayden G. F., Murphy T. F., Hendley J. O. Non-group A streptococci in the pharynx. Pathogens or innocent bystanders? Am J Dis Child. 1989 Jul;143(7):794–797. doi: 10.1001/archpedi.1989.02150190044018. [DOI] [PubMed] [Google Scholar]
  15. Hill H. R., Caldwell G. G., Wilson E., Hager D., Zimmerman R. A. Epidemic of pharyngitis due to streptococci of Lancefield group G. Lancet. 1969 Aug 16;2(7616):371–374. doi: 10.1016/s0140-6736(69)92713-5. [DOI] [PubMed] [Google Scholar]
  16. Hoffmann S. The throat carrier rate of group A and other beta hemolytic streptococci among patients in general practice. Acta Pathol Microbiol Immunol Scand B. 1985 Oct;93(5):347–351. doi: 10.1111/j.1699-0463.1985.tb02899.x. [DOI] [PubMed] [Google Scholar]
  17. Holmström L., Nyman B., Rosengren M., Wallander S., Ripa T. Outbreaks of infections with erythromycin-resistant group A streptococci in child day care centres. Scand J Infect Dis. 1990;22(2):179–185. doi: 10.3109/00365549009037900. [DOI] [PubMed] [Google Scholar]
  18. Ispahani P., Donald F. E., Aveline A. J. Streptococcus pyogenes bacteraemia: an old enemy subdued, but not defeated. J Infect. 1988 Jan;16(1):37–46. doi: 10.1016/s0163-4453(88)96073-2. [DOI] [PubMed] [Google Scholar]
  19. Johnson D. R., Kaplan E. L. Microtechnique for serum opacity factor characterization of group A streptococci adaptable to the use of human sera. J Clin Microbiol. 1988 Oct;26(10):2025–2030. doi: 10.1128/jcm.26.10.2025-2030.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kallings I., Bengtsson S., Christensen P., Holm S. E., Lind L., Kalin M. Antibiotic sensitivity of Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and Branhamella catarrhalis isolated from upper respiratory tract infections in Sweden. Scand J Infect Dis Suppl. 1983;39:100–105. [PubMed] [Google Scholar]
  21. Kaplan E. L., Johnson D. R., Cleary P. P. Group A streptococcal serotypes isolated from patients and sibling contacts during the resurgence of rheumatic fever in the United States in the mid-1980s. J Infect Dis. 1989 Jan;159(1):101–103. doi: 10.1093/infdis/159.1.101. [DOI] [PubMed] [Google Scholar]
  22. Lawal S. F., Odugbemi T., Coker A. O., Solanke E. O. Persistent occurrence of beta-haemolytic streptococci in a population of Lagos school children. J Trop Med Hyg. 1990 Dec;93(6):417–418. [PubMed] [Google Scholar]
  23. Martin D. R. Rheumatogenic streptococci reconsidered. N Z Med J. 1988 Jun 8;101(847 Pt 2):394–396. [PubMed] [Google Scholar]
  24. Martin P. R., Høiby E. A. Streptococcal serogroup A epidemic in Norway 1987-1988. Scand J Infect Dis. 1990;22(4):421–429. doi: 10.3109/00365549009027073. [DOI] [PubMed] [Google Scholar]
  25. Maruyama S., Yoshioka H., Fujita K., Takimoto M., Satake Y. Sensitivity of group A streptococci to antibiotics. Prevalence of resistance to erythromycin in Japan. Am J Dis Child. 1979 Nov;133(11):1143–1145. doi: 10.1001/archpedi.1979.02130110051007. [DOI] [PubMed] [Google Scholar]
  26. McCue J. D. Group G streptococcal pharyngitis. Analysis of an outbreak at a college. JAMA. 1982 Sep 17;248(11):1333–1336. doi: 10.1001/jama.248.11.1333. [DOI] [PubMed] [Google Scholar]
  27. Meier F. A., Centor R. M., Graham L., Jr, Dalton H. P. Clinical and microbiological evidence for endemic pharyngitis among adults due to group C streptococci. Arch Intern Med. 1990 Apr;150(4):825–829. [PubMed] [Google Scholar]
  28. Ogunbi O., Fadahunsi H. O., Ahmed I., Animashaun A., Daniel S. O., Onuoha D. U., Ogunbi L. Q. An epidemiological study of rheumatic fever and rheumatic heart disease in Lagos. J Epidemiol Community Health. 1978 Mar;32(1):68–71. doi: 10.1136/jech.32.1.68. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Potter E. V., Svartman M., Burt E. G., Finklea J. F., Poon-King T., Earle D. P. Relationship of acute rheumatic fever to acute glomerulonephritis in Trinidad. J Infect Dis. 1972 Jun;125(6):619–625. doi: 10.1093/infdis/125.6.619. [DOI] [PubMed] [Google Scholar]
  30. Potter E. V., Svartman M., Mohammed I., Cox R., Poon-King T., Earle D. P. Tropical acute rheumatic fever and associated streptococcal infections compared with concurrent acute glomerulonephritis. J Pediatr. 1978 Feb;92(2):325–333. doi: 10.1016/s0022-3476(78)80036-5. [DOI] [PubMed] [Google Scholar]
  31. Quinn R. W. Comprehensive review of morbidity and mortality trends for rheumatic fever, streptococcal disease, and scarlet fever: the decline of rheumatic fever. Rev Infect Dis. 1989 Nov-Dec;11(6):928–953. doi: 10.1093/clinids/11.6.928. [DOI] [PubMed] [Google Scholar]
  32. Reggiardo Z., Vazquez E. Comparison of enzyme-linked immunosorbent assay and hemagglutination test using mycobacterial glycolipids. J Clin Microbiol. 1981 May;13(5):1007–1009. doi: 10.1128/jcm.13.5.1007-1009.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Sanders E. Bacterial interference. I. Its occurrence among the respiratory tract flora and characterization of inhibition of group A streptococci by viridans streptococci. J Infect Dis. 1969 Dec;120(6):698–707. doi: 10.1093/infdis/120.6.698. [DOI] [PubMed] [Google Scholar]
  34. Schwartz R. H., Shulman S. T. Group C and group G streptococci. In-office isolation from children and adolescents with pharyngitis. Clin Pediatr (Phila) 1986 Oct;25(10):496–502. doi: 10.1177/000992288602501003. [DOI] [PubMed] [Google Scholar]
  35. Seppälä H., Nissinen A., Järvinen H., Huovinen S., Henriksson T., Herva E., Holm S. E., Jahkola M., Katila M. L., Klaukka T. Resistance to erythromycin in group A streptococci. N Engl J Med. 1992 Jan 30;326(5):292–297. doi: 10.1056/NEJM199201303260503. [DOI] [PubMed] [Google Scholar]
  36. Stollerman G. H. Rheumatogenic group A streptococci and the return of rheumatic fever. Adv Intern Med. 1990;35:1–25. [PubMed] [Google Scholar]
  37. Strömberg A., Romanus V., Burman L. G. Outbreak of group A streptococcal bacteremia in Sweden: an epidemiologic and clinical study. J Infect Dis. 1991 Sep;164(3):595–598. doi: 10.1093/infdis/164.3.595. [DOI] [PubMed] [Google Scholar]
  38. Strömberg A., Schwan A., Cars O. Bacteriological and serological aspects of group A streptococcal pharyngotonsillitis caused by group A streptococci. Eur J Clin Microbiol Infect Dis. 1988 Apr;7(2):172–174. doi: 10.1007/BF01963072. [DOI] [PubMed] [Google Scholar]
  39. Tagg J. R., Dajani A. S., Wannamaker L. W., Gray E. D. Group A streptococcal bacteriocin. Production, purification, and mode of action. J Exp Med. 1973 Nov 1;138(5):1168–1183. doi: 10.1084/jem.138.5.1168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Taplin D., Lansdell L., Allen A. M., Rodriguez R., Cortes A. Prevalence of streptococcal pyoderma in relation to climate and hygiene. Lancet. 1973 Mar 10;1(7802):501–503. doi: 10.1016/s0140-6736(73)90324-3. [DOI] [PubMed] [Google Scholar]
  41. Tewodros W., Gedebou M. Nasal carrier rates and antibiotic resistance of Staphylococcus aureus isolates from hospital and non-hospital populations, Addis Ababa. Trans R Soc Trop Med Hyg. 1984;78(3):314–318. doi: 10.1016/0035-9203(84)90105-6. [DOI] [PubMed] [Google Scholar]
  42. Turner J. C., Hayden G. F., Kiselica D., Lohr J., Fishburne C. F., Murren D. Association of group C beta-hemolytic streptococci with endemic pharyngitis among college students. JAMA. 1990 Nov 28;264(20):2644–2647. [PubMed] [Google Scholar]
  43. Veasy L. G., Wiedmeier S. E., Orsmond G. S., Ruttenberg H. D., Boucek M. M., Roth S. J., Tait V. F., Thompson J. A., Daly J. A., Kaplan E. L. Resurgence of acute rheumatic fever in the intermountain area of the United States. N Engl J Med. 1987 Feb 19;316(8):421–427. doi: 10.1056/NEJM198702193160801. [DOI] [PubMed] [Google Scholar]
  44. Wald E. R., Dashefsky B., Feidt C., Chiponis D., Byers C. Acute rheumatic fever in western Pennsylvania and the tristate area. Pediatrics. 1987 Sep;80(3):371–374. [PubMed] [Google Scholar]
  45. el-Kholy A., Sorour A. H., Houser H. B., Wannamaker L. W., Robins M., Poitras J. M., Krause R. M. A three-year prospective study of streptococcal infections in a population of rural Egyptian school children. J Med Microbiol. 1973 Feb;6(1):101–110. doi: 10.1099/00222615-6-1-101. [DOI] [PubMed] [Google Scholar]

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