Assessment of Different Clinical Variables Associated with Group A Streptococcal Throat Infection among Children in Primary Care Practice

Background: Group A streptococcus (GAS) is a major cause of morbidity and mortality
worldwide. An effective targeting strategy is needed for appropriate antibiotic
prescriptions for GAS sore throat. Objective: This study aimed to assess different clinical
variables that can guide management of acute sore throat in children. Methods: A
diagnostic cross-sectional study was conducted on 225 children, aged ≥ 3 years ,with acute
sore throat attending two primary care clinics in Cairo, Egypt. Demographic information,
clinical data and throat swabs were collected from the patients after consent from the
parents. Results: The mean age of the children was 5.8 years and almost half of them
were males, and had on average 3 attacks of sore throat per year. Out of the 225 children
64 (28.4%) had positive GAS cultures and 183 (81.3%) received antibiotics. Of the 183
who received antibiotics, 128 (69.9%) had cultures negative for group A Streptococcus.
There was little difference between those with and without GAS for commonly assessed
clinical variables such as the absence of cough. The absence of skin rash was the only
variable that was statistically significant (92% and 98% respectively, p<0.05) Conclusion:
Clinical variables associated with acute sore throat in Egyptian children cannot accurately
diagnose GAS throat infection.