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Nasopharyngeal colonisation with Streptococcus pneumoniae in malnourished children: a systematic review and meta-analysis of prevalence

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Smith, Holly, German, Esther, Ferreira, Daniela ORCID: https://orcid.org/0000-0002-0594-0902 and Rylance, Jamie ORCID: https://orcid.org/0000-0002-2323-3611 (2019) 'Nasopharyngeal colonisation with Streptococcus pneumoniae in malnourished children: a systematic review and meta-analysis of prevalence'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 113, Issue 5, pp. 227-233.

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Nasopharyngeal colonisation with Streptococcus pneumoniae in malnourished children - a systematic review.pdf - Accepted Version
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Abstract

Background
Streptococcus pneumoniae is an intermittent commensal organism in the nasopharynx. Colonisation is a prerequisite for disease and malnourished children are especially susceptible to severe infection. This systematic review examines published prevalence rates of pneumococcal colonisation in the upper respiratory tract of chronically malnourished children <5 y of age.
Methods
A systematic literature search was performed using MEDLINE, PubMed, Web of Science and Scopus. After screening, relevant studies were assessed for quality using Strengthening the Reporting of Observational Studies in Epidemiology criteria. Colonisation data were extracted and a random effects model was used to pool prevalence estimates.
Results
Nine studies were included. The prevalence rate of S. pneumoniae colonisation in malnourished children during the first month of life ranged from 1.0 to 2.0%, increasing at 2 mo to 53.9–80.0%. Carriage remained similar from 3 to 60 mo at 64.1–88.0%. Meta-analysis showed a pooled prevalence of 67.2% in infants 0–3 mo of age (95% confidence interval [CI] 55.6 to 78.7), 77.9% in infants 3–6 mo of age (95% CI 68.1 to 87.7) and 77.8% in infants 6–60 mo of age (95% CI 73.9–81.6%).
Conclusions
In malnourished children, it is plausible that rates of pneumococcal colonisation are higher than in healthy, well-nourished children. Knowledge of colonisation rates can inform policies on vaccination and ancillary interventions during treatment of malnutrition. Future studies should assess the impact of reducing colonisation on disease rates or transmission in these ‘at-risk’ individuals.

Item Type: Article
Subjects: QW Microbiology and Immunology > Bacteria > QW 142 Gram-positive bacteria (General)
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 320 Child Welfare. Child Health Services.
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 210 Streptococcal infections (General or not elsewhere classified)
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 100 General works
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 105 Deficiency diseases
WS Pediatrics > WS 100 General works
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1093/trstmh/try139
Depositing User: Stacy Murtagh
Date Deposited: 10 Jan 2019 12:20
Last Modified: 17 Sep 2019 08:54
URI: https://archive.lstmed.ac.uk/id/eprint/9850

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