Streptococcus pneumoniae carriage and antibiotic use in children in southwestern Uganda

Abstract

Background: Acute respiratory infection is a significant health threat in children under the age of 5 years in Uganda and can be caused by Streptococcus pneumoniae.

Aim: This study documents caretaker behaviour in seeking treatment for suspected acute respiratory infection in children and estimates the prevalence of S. pneumoniae in healthy and sick children.

Setting: The study was carried out in the catchment region of Bwindi Community Hospital, encompassing the sub-counties of Kanyantorogo, Kayonza and Mpungu in rural southwestern Uganda.

Methods: This cross-sectional study was conducted from January 2023 to August 2023. Caretakers answered questions about the child’s illness, symptoms, sources of treatment and medicines administered. Nasopharyngeal swabs were collected from children and cultured to identify S. pneumoniae using standard microbiological methods. Analyses were conducted using SPSS and ArcPro GIS.

Results: Roughly half of the 422 families sampled reported that the child was ill within the past 2 weeks, the vast majority with symptoms consistent with a possible acute respiratory infection. Most (80%) sought treatment outside the home at a private or public health facility or drug shop. Regardless of treatment source, antibiotics (primarily amoxicillin) were administered 56% of the time. The prevalence of S. pneumoniae was 34% and positively associated with household density, household size and the number of children in the household.

Conclusion: This study documents a high carriage rate of S. pneumoniae in the region and documents a high rate of antibiotic use in the region.

Contribution: This study provides evidence to support a wider assessment of S. pneumoniae carriage and the potential for antibiotic resistance.