PREVALENCE OF NASAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE AMONG CHILDREN AGED 0–5 YEARS ATTENDING A TERTIARY HEALTH FACILITY IN MAKURDI, NIGERIA

PREVALENCE OF NASAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE AMONG CHILDREN AGED 0–5 YEARS ATTENDING A TERTIARY HEALTH FACILITY IN MAKURDI, NIGERIA

ABSTRACT

Nasal colonization by Streptococcus pneumoniae remains a critical public health concern, particularly among children under five years of age, who serve as primary reservoirs for transmission and are highly susceptible to invasive pneumococcal diseases. This study investigates the prevalence, distribution, and determinants of nasal carriage of S. pneumoniae among children aged 0–5 years attending a tertiary healthcare institution in Makurdi, Nigeria. Employing a cross-sectional design, nasal swab samples were collected and analyzed using standard microbiological techniques to isolate and identify pneumococcal strains. The study further evaluates socio-demographic, environmental, and clinical factors associated with colonization. Findings from this research are expected to contribute to improved epidemiological understanding, inform vaccination strategies, and enhance infection control policies. The study underscores the importance of early detection and targeted interventions in reducing pneumococcal disease burden among vulnerable pediatric populations.

CHAPTER ONE: 

INTRODUCTION

1.1 Background to the Study

Streptococcus pneumoniae is a significant human pathogen responsible for a wide spectrum of diseases ranging from mild respiratory tract infections to severe invasive conditions such as pneumonia, meningitis, and septicemia. The organism commonly colonizes the nasopharyngeal region of healthy individuals, particularly young children, without causing immediate symptoms. However, asymptomatic carriage plays a crucial role in the transmission and pathogenesis of pneumococcal infections.

Children aged 0–5 years are particularly vulnerable due to their immature immune systems, frequent exposure in communal settings, and limited hygiene practices. In developing countries such as Nigeria, the burden of pneumococcal diseases remains high due to factors including overcrowding, poor sanitation, limited access to healthcare, and suboptimal vaccination coverage. Despite the introduction of pneumococcal conjugate vaccines (PCVs), nasal carriage persists and continues to serve as a reservoir for infection and transmission.

Understanding the epidemiology of nasal carriage is essential for assessing the effectiveness of vaccination programs and identifying emerging serotypes. In urban centers like Makurdi, where population density and healthcare challenges intersect, there is a pressing need for localized data to inform public health strategies. This study therefore focuses on assessing the prevalence and associated risk factors of S. pneumoniae nasal carriage among children attending a tertiary hospital.

1.2 Statement of the Problem

Pneumococcal infections remain a leading cause of morbidity and mortality among children under five years globally, particularly in low- and middle-income countries. Although vaccination efforts have reduced the incidence of invasive diseases, nasal carriage of S. pneumoniae continues to persist, facilitating transmission and posing risks of antibiotic resistance.

In Nigeria, there is limited up-to-date data on the prevalence and determinants of pneumococcal colonization among young children, especially in specific localities such as Makurdi. The lack of comprehensive epidemiological data hinders effective planning and evaluation of intervention strategies. Furthermore, factors such as overcrowding, poor hygiene, and inconsistent immunization practices may contribute to sustained carriage rates.

This study seeks to bridge this knowledge gap by investigating the extent of nasal carriage and identifying contributing factors, thereby providing evidence-based recommendations for improved pediatric health outcomes.

1.3 Objectives of the Study

General Objective:
To assess the prevalence of nasal carriage of Streptococcus pneumoniae among children aged 0–5 years attending a tertiary healthcare facility in Makurdi.

Specific Objectives:

• To determine the prevalence rate of S. pneumoniae nasal colonization among the study population.
• To identify socio-demographic and environmental factors associated with nasal carriage.
• To evaluate the relationship between vaccination status and pneumococcal colonization.
• To assess patterns of antimicrobial susceptibility of isolated strains.

1.4 Research Questions

• What is the prevalence of nasal carriage of Streptococcus pneumoniae among children aged 0–5 years in the study area?
• What factors influence the colonization of S. pneumoniae in this population?
• Is there a significant relationship between vaccination status and nasal carriage?
• What are the antimicrobial resistance patterns of the isolated organisms?

1.5 Hypotheses

• H??: There is no significant prevalence of nasal carriage of Streptococcus pneumoniae among children aged 0–5 years in Makurdi.
• H??: There is a significant prevalence of nasal carriage of Streptococcus pneumoniae among children aged 0–5 years in Makurdi.
• H??: Vaccination status has no significant effect on nasal carriage of S. pneumoniae.
• H??: Vaccination status significantly affects nasal carriage of S. pneumoniae.

1.6 Significance of the Study

This study holds considerable relevance for public health practitioners, policymakers, and healthcare providers. By providing empirical data on the prevalence and determinants of pneumococcal carriage, the research will support evidence-based decision-making in pediatric healthcare.

Healthcare institutions will benefit from insights into infection control practices and antimicrobial resistance patterns, enabling improved treatment protocols. The findings will also contribute to optimizing vaccination strategies, particularly in assessing the effectiveness of existing pneumococcal vaccines.

Academically, the study will serve as a valuable reference for future research in microbiology, epidemiology, and public health, particularly within the Nigerian context.

1.7 Scope of the Study

This study is confined to children aged 0–5 years attending a tertiary healthcare facility in Makurdi. It focuses specifically on the detection of nasal carriage of Streptococcus pneumoniae, associated risk factors, and antimicrobial susceptibility patterns. The study does not extend to other age groups or pathogens.

1.8 Limitations of the Study

The study may be constrained by limited financial resources, which could affect sample size and laboratory analysis. Time limitations and reliance on hospital-based sampling may also restrict the generalizability of findings to the broader population. Additionally, caregiver-reported data may introduce response bias.