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Background & Objectives: Respiratory-tract infections and invasive disease caused by Streptococcus pneumoniae (Spn) are a major
cause of childhood deaths worldwide. Colonisation of Spn is a prerequisite to pneumococcal disease and carriage is high in children
under five years. Chronic malnutrition impairs immune responses, rendering children more susceptible to infection. This is reflected
by higher incidence of disease. As studies have suggested the paradigm of chronic malnutrition leading to increased rates of Spn
carriage, the aim of this systematic review is to determine the prevalence rate of pneumococcal carriage in the upper respiratory tract
of chronically malnourished children under the age of five years.
Methods: A systematic search of the existing literature reporting upper respiratory tract prevalence rate of Spn colonisation in
malnourished children under the age of five, using Medline, PubMed, Web of Science and Scopus, was carried out. An eligibility
criteria was used to include relevant papers.
Findings: The prevalence rate of Spn colonisation in malnourished children under the age of five was high. Prevalence at birth ranged
from 1.0-2.0% and this greatly increases at two months to 53.9-80.0%. Carriage remains high from three months to 60 months at 64.1-
88.0%. Meta-analysis showed a pooled prevalence of 67.2% in 0-3 months infants (95% CI, 55.6-78.7%), 77.9% in 3-6 months infants
(95% CI, 68.1-87.7%) and 77.8% in 6-60 months infants (95% CI, 73.9-81.6%).
Conclusion: In chronically malnourished children, pneumococcal carriage is frequent. However, as data is limited, further research
is needed to investigate the aetiology and the strength of this association.
Biography
Holly Smith is a 5th year Medical student, intercalating in an MRes in Clinical Sciences at University of Liverpool. She completed systematic review and metaanalysis from September 2016 to January 2017 at Liverpool School of Tropical Medicine, under the supervision of Dr Daniela Ferreira.