Incidence of streptococcal infections as a function of grade, race, sex, and socioeconomic level.

The purpose of the present study was to determine the incidence of a group A beta hemolytic streptococci (AHS) in the throats of sample population of children from 3 elementary schools. Relationships between AHS and race, sex and socio-economic level were ascertained. This study was also undertaken to demonstrate that in the interest of primary prevention of rheumatic fever, case finding of children with AHS can be a nurse oriented task in which lay volunteers can be utilized without sacrificing technical accuracy. Of the total sample (371) 102 showed the presence of AHS in their throats. Of the 102, 40 children were afibrile and asymptomatic. Sixty-two children with positive cultures presented one or more of the following symptoms: (1) fever ranging from 99.6° to 102.8°F; (2) malaise; (3) cough; (4) headache; (5) laryngitis; (6) sore throat; (7) exudate in the nose or throat. Eighty-five additional children with negative cultures also demonstrated one or more of the above symptoms. A higher incidence of AHS was found in non-whites and in children attending the school with the lowest socio-economic level which is located at a relatively higher elevation. A significant difference did exist between grades checked (kindergarten - 6th). In general, incidence decreased as a function of grade increase. Incidence did not differ as a function of sex. Lay volunteers were taught the technique of throat culture along with registered nurses who also volunteered for this study. The volunteers and nurses cultured an approximately equal number of throats with an approximately equally number of positive children. The study indicated that there are a large number of children in the three sample schools who are carrying AHS in their throats and remain either asymptomatic or undiagnosed and in either case, untreated. The author recommends that the present study be repeated and enlarged to further determine the epidemiological pattern of AHS in Utah school children.