Prevalence of Colonization not causing disease in young well children is 12% Prevalence of Streptococcal Pharyngitis and Streptococcal Carriage in Children: A Meta-analysis -- Shaikh et al. 126 (3): e557 -- PediatricsClipped from: http://pediatrics.aappublications.org/cgi/content/abstract/126/3/e557
Prevalence of Streptococcal Pharyngitis and Streptococcal Carriage in Children: A Meta-analysisNader Shaikh, MD, MPHa, Erica Leonard, MDb,Judith M. Martin, MDc
Divisions of a General Academic Pediatrics and
c Pediatric Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
b Swedish Family Medicine Residency Program, Seattle, Washington
OBJECTIVES Prevalence estimates can help clinicians make informed decisions regarding diagnostic testing of children who present with symptoms of pharyngitis. We conducted a meta-analysis to determine the (1) prevalence of streptococcal infection among children who presented with sore throat and (2) prevalence of streptococcal carriage among asymptomatic children.
METHODS We searched Medline for articles on pediatric streptococcal pharyngitis. We included articles in our review when they contained data on the prevalence of group A Streptococcus (GAS) from pharyngeal specimens in children who were younger than 18 years. Two evaluators independently reviewed, rated, and abstracted data from each article. Prevalence estimates were pooled in a meta-analysisand stratified according to age group.
RESULTS Of the 266 articles retrieved, 29 met all inclusion criteria. Among children of all ages who present with sore throat, the pooled prevalence of GAS was 37% (95% confidence interval [CI]: 32%–43%). Children who were younger than 5 years had a lower prevalence of GAS (24% [95% CI: 21%–26%]). The prevalence of GAS carriage among well children with no signs or symptoms of pharyngitis was 12% (95% CI: 9%–14%).
CONCLUSIONS Prevalence rates of GAS disease and carriage varied by age; children who were younger than 5 years had lower rates of throat cultures that were positive for GAS.
Key Words: Streptococcus • carriage • pediatrics • prevalence • meta-analysis
Abbreviations: GAS = group A Streptococcus • CI = confidence interval
Accepted May 20, 2010.