Surveillance of Streptococcal Infections in Children in India
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Útdráttur
Lýsing
This is an epidemiological study on the incidence of Group A beta hemolytic streptococcal (GAS) infections (both pharyngitis and impetigo) in school-age children in two rural area of India: surveillance in four schools, in the north in the Punjab near Chandigarh conducted by the medical staff of the Department of Community Medicine Post-graduate Institute for Medical Research and Training (PGI); and in one school in the south in Tamil Nadu near Vellore conducted by the medical staff of the Department of Community Medicine, Christian Medical College (CMC).
Children and their teachers were questioned weekly for a history of GAS infection. On all children suspected from the history of a streptococcal infection of the pharynx or the skin, a physical examination of nose, throat, ears and skin was performed and throat culture and or skin culture and blood sample were taken for subsequent antibody determination. The diagnosis of GAS infection was made on the basis of established clinical criteria and the isolation of GAS from throat and skin lesion cultures.
The surveillance of the children was completed in March '04 in Vellore, and in April '04 in Chandigarh. For the next year, there will be extensive analysis of the clinical data; analysis of the isolated GAS for emm type and other bacteriologic characteristics; and epidemiologic analysis in a search for patterns of distribution of GAS infections by sex, age, school and session.
The general objectives have been:
To establish population-based surveillance to determine the incidence of GAS infection in school children age 7-11, to characterize the M protein of the newly isolated strains of GAS by emm gene sequencing,
1. to identify surrogate markers of protective immunity relevant to vaccine development such as serum antibody to the M type-specific peptides and cysteine protease, and
2. to define the molecular epidemiology of GAS in terms of those characteristics that are relevant to vaccine-induced immunity.
Information from this study is needed to plan an eventual trial of a vaccine(s) if and when one is available. Information on the antigenic structure of GAS isolated in India will be needed for planning vaccine composition. Information on incidence is needed to determine the size of a future cohort that will be needed to obtain a statistically significant result on vaccine efficacy.
A vaccine trial is not part of this study, nor was there any intervention, other than diagnostic procedures and antibiotic treatment of all who develop a GAS infection.
Dagsetningar
| Síðast staðfest: | 02/25/2014 |
| Fyrst lagt fram: | 06/18/2006 |
| Áætluð skráning lögð fram: | 06/18/2006 |
| Fyrst sent: | 06/20/2006 |
| Síðasta uppfærsla lögð fram: | 12/12/2019 |
| Síðasta uppfærsla sett upp: | 12/15/2019 |
| Raunverulegur upphafsdagur náms: | 07/02/2001 |
| Áætlaður dagsetningu rannsóknar: | 02/25/2014 |
Ástand eða sjúkdómur
Stig
Hæfniskröfur
| Kyn sem eru hæf til náms | All |
| Tekur við heilbrigðum sjálfboðaliðum | Já |
| Viðmið | - INCLUSION CRITERIA: All students (approximately 225-250) attending four classes in four rural schools, grades 2-5, in rural villages near Chandigarh, and all students in classes 2-6 approximately 225-250 attending one rural village school near Vellore were asked to participate. Approximately an equal number of boys and girls participated. Selection of the schools for the study was determined by such factors as the accessibility to a rural regional clinic, housing facilities for medical staff, and passable tertiary roads to the villages and the schools. EXCLUSION CRITERIA: All volunteers had a history of acute rheumatic fever and acute glomerulonephritis and evidence of rheumatic fever and rheumatic heart disease on physical examination at the initial survey were excluded from the study. Excluded also was a child with a compromising illness such as cystic fibrosis that might require frequent or intermittent antibiotic treatment. |
