Elsevier

Mayo Clinic Proceedings

Volume 81, Issue 9, September 2006, Pages 1172-1176
Mayo Clinic Proceedings

ORIGINAL ARTICLE
Population-Based Prevalence of Repeated Group A β-Hemolytic Streptococcal Pharyngitis Episodes

https://doi.org/10.4065/81.9.1172Get rights and content

OBJECTIVE

To define the population-based 3-year period prevalence of repeated group A β-hemolytic streptococcal (GABHS) pharyngitis episodes in children between 4 and 15 years of age.

PATIENTS AND METHODS

Residents of Rochester, Minn (age, 4-15 years), who had 3 or more GABHS pharyngitis episodes in 1 year, at least 1 month apart, between January 1, 1996, and December 31, 1998, were identified using the resources of the Rochester Epidemiology Project (N=536). Pharyngitis episodes (evidence of a sore throat with or without presence of fever) followed by either a positive rapid streptococcus test result or a positive plate culture test result were considered positive GABHS episodes. Age- and sex-specific prevalence rates were calculated, assuming that all residents 4 to 15 years of age in Rochester during 1996 to 1998 were at risk.

RESULTS

A total of 208 children met our definition for repeated GABHS episodes between 1996 and 1998 and were included in this study. Approximately 1% of children between the ages of 4 and 15 years experienced repeated GABHS pharyngitis episodes between 1996 and 1998. This estimate increased to approximately 2% among children 4 to 6 years of age and decreased to 0.1% among children 13 to 15 years old.

CONCLUSION

A relatively small proportion (1%) of children between 4 and 15 years of age experienced repeated GABHS episodes in a 3-year period; however, this proportion represents a substantial number of children who are affected at the population level. Given the increased costs associated with treating repeated GABHS episodes, further studies are necessary to determine how best to reduce episodes and treatment costs in this age group.

Section snippets

Description of Study Resources

Olmsted County, Minnesota, is served by a largely unified medical care system that has accumulated comprehensive clinical records since the early 1900s. The REP is a unique resource that links and indexes the records of virtually all providers of medical care to Olmsted County residents.6 The result is the linkage and availability of medical records (including details of every outpatient visit to offices, clinics, and emergency departments, as well as every laboratory result and all

RESULTS

The median age of the children in our study was 6.8 years (range, 4.1-13.8 years), and slightly less than half of the children were female (47.1%). A total of 1069 GABHS episodes were documented, with a median of 5 episodes per child (range, 3-14 episodes).

Treatment data were available for 1011 GABHS episodes (94.6%). Overall, 799 episodes (79.0%) were treated with a penicillin or penicillin-related antibiotic (amoxicillin, penicillin V potassium, or a combination of penicillin G benzathine and

DISCUSSION

Our data suggest that approximately 1% of children between the ages of 4 and 15 years will experience repeated GABHS pharyngitis episodes in a given 3-year period. This estimate increases to approximately 2% among children 4 to 6 years of age and decreases to 0.1% among children 13 to 15 years old. This estimate differs from that of Pichichero et al,5 who estimated that approximately 13% of the GABHS episodes in their study population recurred later than 30 days but within 60 days of the

CONCLUSION

Taken together, our data suggest that a relatively small proportion (1%) of children between 4 and 15 years of age will experience repeated GABHS episodes in a 3-year period; however, this proportion represents a substantial number of children who are affected at the population level. Given the increased treatment costs associated with treating repeated GABHS episodes, further studies are necessary to determine how best to reduce episodes and treatment costs in this group of children.

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