Post-vaccination Streptococcus pneumoniae Nasopharyngeal Carriage, Antimicrobial Sensitivity Patterns and Associated Factors Among Under Five Children, in Burayu Town, Oromia, Ethiopia

Abstract

Background: - Streptococcus pneumoniae causes high morbidity and mortality, particularly in under five children. Nasopharyngeal carriage predisposes individuals to pneumococcal infection and horizontal spread within the community. In Ethiopia, S. pneumoniae is the predominant causative agent of pneumonia. Objectives:-To assess post-vaccination S. pneumoniae Nasopharyngeal carriage, antimicrobial sensitivity patterns and associated factors among under five children from October 1- November 15, 2022 in Burayu town, Oromia, Ethiopia. Methods and Materials: - A Community based cross-sectional study design was conducted from October 1- November 15, 2022 in Burayu town, Oromia, Ethiopia. A total of 422 under five children were selected through systematic random sampling technique. A nasopharyngeal specimen collected by gentle insertion of sterile flexible plastic applicator rayon tipped swab. A specimen was cultured on blood agar and the isolates tested for optochin sensitivity and bile solubility.The antimicrobial sensitivity testing was performed by using disk diffusion method. Data were collected by face-to-face interviews, entered by epi-info version 7.2 and analyzed by SPSS version 27. Descriptive statistics and binary logistic regression analysis were done and a P value < 0.05 was considered statistically significant. Result: From 414 participant, 259(62.6%; 95%CI: 57.7-67.2%) children were found to be carrier for S. pneumoniae. Cotrimoxazole and Oxacillin resistant isolates accounted for 80.3% (208/259) and 71.4% (185/259), respectively. Multidrug resistance was seen in 38.2% (99/259) of isolates. Children living in house with more or equal to two rooms, stay during cooking outside cooking room and who had taken antibiotic in the last 2 weeks were protective/ at less risk of carriage and on the other hand, children who had live with sibling(s) <5years old, children who live with sibling(s) 5-15years old shared bed with parent, had history of respiratory tract infections and who still on breast feeding were risk factors significantly associated with post-vaccination S. pneumoniae carriage. Conclusions: There is 62.6% magnitude of post-vaccination S. pneumoniae carriage. Most S. pneumoniae isolates were resistant to antimicrobial used. Children who live with sibling(s) <5years old, children who live with sibling(s) 5-15years old shared bed with parent, had history of respiratory tract infections and who still on breast feeding risk factors significantly associated with post-vaccination S. pneumoniae carriage