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Prevalence of Group A beta-haemolytic Streptococcus isolated from children with acute pharyngotonsillitis in Aden, Yemen.
[acute rheumatic fever]
To
estimate
the
prevalence
of
Group
A
beta
-haemolytic
streptococcus
(
GAS
)
and
non-
GAS
infections
among
children
with
acute
pharyngotonsillitis
in
Aden
,
Yemen
,
to
evaluate
the
value
of
a
rapid
diagnostic
test
and
the
McIsaac
score
for
patient
management
in
this
setting
and
to
determine
the
occurrence
of
emm
genotypes
among
a
subset
of
GAS
isolated
from
children
with
acute
pharyngotonsillitis
and
a
history
of
acute
rheumatic
fever
(
ARF
)
or
rheumatic
heart
disease
(
RHD
)
.
Group
A
beta
-haemolytic
streptococcus
infections
in
school
-aged
children
with
acute
pharyngotonsillitis
in
Aden
,
Yemen
,
were
diagnosed
by
a
rapid
GAS
antigen
detection
test
(
RADT
)
and
/
or
GAS
culture
from
a
throat
swab
.
The
RADT
value
and
the
McIsaac
screening
score
for
patient
management
were
evaluated
.
The
emm
genotype
of
a
subset
of
GAS
isolates
was
determined
.
Group
A
beta
-haemolytic
streptococcus
pharyngotonsillitis
was
diagnosed
in
287
/
691
(
41
.
5
%
;
95
%
CI
37
.
8
-
45
.
3
)
children
.
Group
B
,
Group
C
and
Group
G
beta
-haemolytic
streptococci
were
isolated
from
4
.
3
%
children
.
The
RADT
had
a
sensitivity
of
238
/
258
(
92
.
2
%
)
and
specificity
of
404
/
423
(
95
.
5
%
)
against
GAS
culture
.
A
McIsaac
score
of
≥
4
had
a
sensitivity
of
93
%
and
a
specificity
of
82
%
for
confirmed
GAS
infection
.
The
emm
genotypes
in
21
GAS
isolates
from
children
with
pharyngitis
and
a
history
of
ARF
and
confirmed
RHD
were
emm
87
(
11
)
,
emm
12
(
6
)
,
emm
28
(
3
)
and
emm
5
(
1
)
.
This
study
demonstrates
a
very
high
prevalence
of
GAS
infections
in
Yemeni
children
and
the
value
of
the
RADT
and
the
McIsaac
score
in
this
setting
.
More
extensive
emm
genotyping
is
necessary
to
understand
the
local
epidemiology
of
circulating
strains
.
Diseases
Validation
Diseases presenting
"very high prevalence"
symptom
acute rheumatic fever
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