Magnitude of Streptococcus pneumoniae Among Under-Five Children with Symptom of Acute Respiratory Infection at Hiwot Fana Specialized University Hospital, Harar, Ethiopia: Associated Risk Factors and Antibacterial Susceptibility Patterns

Abstract

Purpose

Streptococcus pneumoniae is the major cause of pneumoniae infection among under-five children that leads to high morbidity and mortality. Thus, the aim of this study was to determine the magnitude of Streptococcus pneumoniae in under-five children of an acute respiratory infection, assess its antimicrobial susceptibility patterns, and define the associated factors.

Methods

An institutional-based cross-sectional study was conducted on a total of 384 under-five children of acute respiratory infection attending outpatient department of Hiwot Fana Specialized University Hospital, Harar, Ethiopia, from March 1 to 30, 2020. Socio-demographic and clinical data were collected from the study participants using a structured questionnaire. Sputum samples were collected and processed to identify Streptococcus pneumoniae pathogen using the culture and biochemical tests as per the standard procedures. The Kirby–Bauer disk diffusion method was used for antimicrobial susceptibility testing. Data were entered into Epi-data version 3.1 and analyzed by using Statistical Product and Service Solutions version 22.

Results

The proportion of Streptococcus pneumoniae in under-five children with acute respiratory infection was 11.2%. About 50% of isolated Streptococcus pneumoniae was resistant to tetracycline and cotrimoxazole, whereas more than 90% of it was susceptible to Ceftriaxone and amoxicillin-clavulanate. Children who lived in rural areas were 3.6 times more likely to have S. pneumoniae compared to children who lived in urban areas (AOR: 3.6, 95% CI: 1.2–11) and children with familysmokers in a house were 3 times at risk to be infected with S. pneumoniae (AOR: 3, 95% CI: 1.8–8.0).

Conclusion

High antimicrobial resistance of S. pneumoniae against tetracycline and cotrimoxazole was observed and children who lived in rural areas and live with a family of cigarette smoker are factors associated with Streptococcus pneumoniae. Therefore, providing health educations to the family of children rural residents and isolating smokers from the house where children lived are recommended actions to reduce bacteria caused by Streptococcus pneumoniae.

Keywords:

• antibiotic susceptibility
• children under-five
• S. pneumoniae
• Hiwot Fana Specialized University Hospital
• Harar
• Ethiopia

Acknowledgments

The authors would express great gratitude to Hiwot Fana Specialized University Hospital for providing Sponsorship.

Abbreviations

ARI, Acute Respiratory Infection; HRERC, Institutional Health Research Ethics, and Review Committee; HFSUH, Hiwot Fana Specialized University Hospital.

Data Sharing Statement

The raw data set used/analyzed during the current study is available from Mr. Dejene Bayu on a reasonable request.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; and agreed to submit to the current journal; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work.

Disclosure

The authors report that there is no potential conflicts of interest for this work.

Additional information

Funding

Fund for data collection for this research was covered by Haramaya University College of Health and Medical Sciences.