Bacterial Etiology of Respiratory Tract Infections among Ambulatory School Children in Moshi Municipality, Tanzania

James Samwel Ngocho, Caroline Amour, Margaretha Sariko, Blandina Theophil Mmbaga, Gibson Sammy Kibiki
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Background: Respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. Management of respiratory tract infections poses a challenge in developing countries particularly due to limited resources for bacterial identification. The objective of this study was to describe bacterial etiological agents causing respiratory tract infections and their resistance patterns among ambulatory school children in Moshi municipality, Tanzania.

Methodology: A cross sectional community based study was conducted, from January to March 2014 in 4 primary schools in Moshi Municipality. All school children available at the time of study were assessed for respiratory symptoms, those with self-reported respiratory tract symptoms for four days or more were eligible for participation. While those on medication and those who completed oral medication within 15 days prior to screening were excluded. Nasopharyngeal and throat swabs were collected from eligible children. Isolates were tested for sensitivity against commonly used antibiotics.

Results: Of 2,016 screened school children, 474 (23.5%) had respiratory tract symptoms. Respiratory tract bacterial pathogens were isolated from 123 (73.7%) of 167 children whose nasopharyngeal and throat swabs were collected, three children did no show for swab collection. S. aureus was the most prevalent isolate 68 (55.3%) followed by S. pneumoniae 43 (35.0%), and the least prevalent isolate was K. pneumoniae 7 (5.7%). Majority of isolated upper respiratory tract bacteria were resistant to ampicillin. S. pneumoniae exhibited the highest rate of the resistance whereby, 33 (91.7%) isolates were resistant to ampicillin. However, the resistance of isolates to cotrimoxazole was found to be low. Gentamicin and ceftriaxone were effective against most isolates.

Conclusion: Prevalence of respiratory tract symptoms was high among ambulatory school children who were presumed to be healthy. The observed high resistance of isolates might be due to unnecessary prescription of antibiotics, and counterfeit drugs. There is a need to strengthen school health program, in order to identify children with respiratory tract infections and refer them to a health facility for further evaluation.