Nasopharyngeal carriage of Streptococcus pneumoniae is a determinant for invasive
pneumococcal disease, which often complicates homozygous
sickle cell disease. Here, we determined the nasopharyngeal carriage rate of S. pneumoniae in Ugandan children with homozygous
sickle cell disease, who attended the outpatient Sickle Cell Clinic at Mulago National Referral hospital in Kampala, Uganda.
RESULTS: S. pneumoniae occurred in 27 of the 81 children with homozygous
sickle cell disease (giving a carriage rate of 33%, 27/81). Twenty three children were previously hospitalized of whom S. pneumoniae occurred in only two (9%, 2/23), while among the 58 who were not previously hospitalized it occurred in 25 (43%, 25/58, χ2 = 8.8, p = 0.003), meaning there is an association between high carriage rate and no hospitalization. Two children previously immunized with the pneumococcal
conjugate vaccine did not carry the organism. Prior antimicrobial usage was reported in 53 children (65%, 53/81). There was high resistance of pneumococci to
penicillin (100%, 27/27) and trimethoprime-
sulfamethoxazole (97%, 26/27), but low resistance to other antimicrobials. Of the 70 children without
sickle cell disease, S. pneumoniae occurred in 38 (54%, 38/70) of whom 43 were males and 27 females (53% males, 23/43, and 56% females, 15/27).
CONCLUSION: