Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis

• Published in: Pediatrics (Evanston) Vol. 126; no. 3; pp. e557 - e564
• Main Authors: Shaikh, Nader, Leonard, Erica, Martin, Judith M
• Format: Journal Article
• Language: English
• Published: United States American Academy of Pediatrics 01-09-2010
• Subjects: Adolescent; Carrier State - epidemiology; Child; Child, Preschool; Humans; Infant; Meta-analysis; Pediatrics; Pharyngitis - epidemiology; Pharyngitis - microbiology; Prevalence; Streptococcal Infections - epidemiology; Streptococcus; Streptococcus infections; Streptococcus pyogenes - isolation & purification; Throat
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2009-2648

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.
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-analysis and stratified according to age group.
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%).
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.