Marit Helen Andersen, Åsmund Hermansen, Kari Gire Dahl, Kjersti Lønning, Käthe Birgitte Meyer, Tone Karine Vidnes, Astrid Klopstad Wahl
Profiles of health literacy and digital health literacy in clusters of hospitalised patients: a single-centre, cross-sectional study
BMJ open
streptococcus pyogenes causes 500 000 deaths per year globally occur disproportionately lowincome middleincome countries roles pyogenes skin pharyngeal carriage transmission unclear aimed investigate clinical epidemiology household transmission dynamics pyogenes asymptomatic carriage infection highburden setting 1year prospective longitudinal household cohort study recruiting healthy participants households sukuta gambia households eligible comprised least three members including one child younger 18 years excluded half household members declined participate households identified random gps coordinates derived census data monthly visits pharyngeal normal skin swabs collected pyogenes culture sociodemographic data recorded interview incident pharyngitis pyoderma infections captured cultured isolates underwent emm genotyping primary outcome measures incidence pyogenes carriage disease additional outcomes prevalence pyogenes skin pharyngeal carriage pyogenes skin pharyngeal clearance time pyogenes emm type risk factors carriage disease events household secondary attack rate emmlinked household transmission events study registered clinicaltrialsgov nct05117528 july 27 2021 sept 28 2022 442 participants enrolled 44 households median age 15 years iqr 628 233 53 female identified 17 pharyngitis 99 pyoderma events 49 pharyngeal 39 skin pyogenes carriage acquisition events mean monthly prevalence 14 95 ci 1119 pyogenes pharyngeal carriage 12 0916 pyogenes skin carriage incidence 120 per 1000 personyears 95 ci 87166 pyogenes pharyngeal carriage 124 per 1000 personyears 90170 pyogenes skin carriage 51 per 1000 personyears 3184 pyogenes pharyngitis 263 per 1000 personyears 212327 pyogenes pyoderma pharyngeal carriage risk higher rainy season hr 567 95 ci 2191469 larger households per additional person 103 100105 pharyngitis risk rainy season 300 110822 household size 104 102107 skin carriage risk affected season household size lower female male participants 045 022092 highest children younger 5 years compared adults 2269 30816721 similar findings pyoderma female sex 034 019061 age 5 years 700 2781764 median clearance time carriage acquisition 40 days skin iqr 3570 pharynx 3573 mean household secondary attack rate 49 95 ci 3563 epidemiologically linked pyogenes events 074 0312 emmlinked pyogenes events 204 carriage disease events emm types available 179 88 18 emmlinked betweenvisit household transmission events identified pyoderma common source pyogenes household transmissions 11 61 18 emmlinked transmissions pharynx skin skin pharynx transmission events observed pyogenes carriage infection common gambia particularly children events nonhousehold acquisitions skin carriage pyoderma important role pyogenes household transmission bidirectional transmission skin pharynx occurs wellcome trust chadwick trust fonds national de la recherche scientifique belgium european society paediatric infectious diseases medical research council uk