Persistent carriage of <i>Streptococcus pneumoniae</i> and its influencing factors among children in kindergartens

YANG Shimin; DENG Wenjun; ZHANG Jingfeng; LI Pingyuan; ZHOU Junli; YAO Zhenjiang; YE Xiaohua

doi:10.16462/j.cnki.zhjbkz.2024.05.019

Volume 28 Issue 5

May 2024

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YANG Shimin, DENG Wenjun, ZHANG Jingfeng, LI Pingyuan, ZHOU Junli, YAO Zhenjiang, YE Xiaohua. Persistent carriage of Streptococcus pneumoniae and its influencing factors among children in kindergartens[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 613-620. doi: 10.16462/j.cnki.zhjbkz.2024.05.019

Citation:

YANG Shimin, DENG Wenjun, ZHANG Jingfeng, LI Pingyuan, ZHOU Junli, YAO Zhenjiang, YE Xiaohua. Persistent carriage of Streptococcus pneumoniae and its influencing factors among children in kindergartens[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 613-620. doi: 10.16462/j.cnki.zhjbkz.2024.05.019

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Persistent carriage of Streptococcus pneumoniae and its influencing factors among children in kindergartens

doi: 10.16462/j.cnki.zhjbkz.2024.05.019

Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China

Funds:

National Natural Science Foundation of China 81973069

Guangdong Basic and Applied Basic Research Foundation 2023A1515011583

Guangdong Basic and Applied Basic Research Foundation 2019A1515010915

Key Projects of Guangdong Educational Committee 2022ZDZX2033

More Information

Corresponding author: YE Xiaohua, E-mail: smalltomato@163.com
Received Date: 2023-05-15
Rev Recd Date: 2023-08-24

Available Online: 2024-06-05

Publish Date: 2024-05-10

Abstract

Abstract

Objective To explore the prevalence and influencing factors of persistent carriage of Streptococcus pneumoniae (S. pneumoniae) in kindergarten children. Methods A multi-stage stratified cluster sampling method was used in this study. Healthy children were sampled from six kindergartens in Shunde District, Foshan City. All children underwent three nasal swab samplings, followed by isolation and identification of S. pneumoniae. Univariate chi-square tests and multivariate logistic regression analysis models were used to analyze the factors influencing persistent carriage of S. pneumoniae in children. Given the non-independence and strong correlation of the number of positive cases within classes across three samples, this study has developed three separate multivariable logistic regression analysis models (namely, models 1 to 3). Apart from the variable "number of positive cases within the class", all three models maintain consistency in controlling for confounding factors and in the analytical methods used. A random forest model was applied to rank the importance of factors associated with persistent carriage of S. pneumoniae. Results The persistence carriage rate of S. pneumoniae in children was 6.6%. The results of the multivariable logistic regression analysis in model 1 indicated that a higher number of positive cases within a class was associated with an increased rate of persistent carriage of S. pneumoniae, showing a monotonic increasing trend. Compared to the group with 0 to < 4 positive cases, the odds ratios for other groups were 2.35 (95% CI: 1.12-4.90, P=0.023), 5.86 (95% CI: 2.75-12.49, P < 0.001), and 9.43 (95% CI: 4.68-19.02, P < 0.001), respectively. The rate of persistent carriage of S. pneumoniae decreased with increasing age. Compared to the group aged 0 to < 3 years, the odds ratios for other age groups were 0.38 (95% CI: 0.20-0.72, P=0.003), 0.29 (95% CI: 0.15-0.55, P < 0.001), and 0.29 (95% CI: 0.14-0.60, P=0.001), respectively. A history of allergic diseases within the past year was identified as a protective factor for the persistent carriage of S. pneumoniae, with an odds ratio of 0.44 (95% CI: 0.20-0.98, P=0.045). The findings from models 2 and 3 were consistent with those from model 1. Conclusions An increased number of positive cases within a class is a significant risk factor for the persistent carriage of S. pneumoniae among kindergarten children; whereas, an increase in age and a history of allergic diseases within the past year serve as protective factors against the persistent carriage of S. pneumoniae in this population.
- Streptococcus pneumoniae,
- Carriage,
- Influencing factors,
- Child

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References(21)

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