Next Article in Journal
Pacific Adaptation of Tools for Implementing Rheumatic Heart Disease Control Programmes (TIPs)
Previous Article in Journal
Proceedings of the 13th Alcohol Hangover Research Group Meeting in Dresden, Germany
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Proceedings
Volume 124
Issue 1
10.3390/proceedings2025124012
proceedings-logo
Submit to this Journal
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Abstract

Prevalence, Risk Factors, and Strain Distribution of Group A Streptococcus Carriage Among Indigenous Children in the Southwest United States †

by
Catherine G. Sutcliffe
1,*,
Victoria M. Sergent
1,
Joyselynn Pitalua
1,
Sopio Chochua
2,
Christopher J. Gregory
2,
Chloe Hurley
1,
Zhongya Li
3,
Saundra Mathis
3,
Lesley McGee
2,
Jennifer Onukwube Okaro
2,
Theresa Tran
2,
Robert Weatherholtz
1 and
Laura L. Hammitt
1
1
Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21231, USA
2
Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
3
ASRT Inc., Contractor to Pneumonia and Streptococcus Laboratory Branch, Centers for Disease Control and Prevention, Smyrna, GA 30080, USA
*
Author to whom correspondence should be addressed.
†
Presented at the 22nd Lancefield International Symposium on Streptococci and Streptococcal Diseases, Brisbane, Australia, 1–5 June 2025.
Proceedings 2025, 124(1), 12; https://doi.org/10.3390/proceedings2025124012
Published: 13 August 2025
(This article belongs to the Proceedings of The 22nd Lancefield International Symposium on Streptococci and Streptococcal Diseases (LISSSD 2025))
Versions Notes

  • Background
Indigenous individuals in the Southwest United States are disproportionately affected by Group A Streptococcus (GAS) infections. Understanding prevalence and risk factors for carriage and characteristics of carriage isolates provides critical insight to inform the use of existing interventions and vaccine development and evaluation.
  • Methods
In Navajo Nation and White Mountain Apache Tribal lands, cross-sectional car-riage studies were conducted among Indigenous children aged 0–14 years (n = 768) in 2019 and 0–4 years (n = 498) in 2022–2023. Study activities included a questionnaire, medical chart review, and collection and culture of an oropharyngeal sample. Isolates were sequenced to determine emm type. We evaluated GAS carriage prevalence and risk factors and calculated the percentage of emm types covered by a 30-valent vaccine in development.
  • Results
Carriage prevalence among children aged <5 and 5–14 years was 4.2% (n = 33/792; no difference between studies) and 18.1% (n = 86/474), respectively. Prevalence was higher among males, older children, and children with a prior GAS infection. The top three emm types were 12 (26.9%), 91 (13.5%), and 1 (8.4%). Emm clusters varied by age, with more emm types from the D1–5 cluster among children 5–14 years (28% vs. 6%; p = 0.015). The percentage of emm types covered by the 30-valent vaccine was 74%.
  • Conclusions
Similar to the general U.S. population, carriage prevalence was higher among school-aged children, suggesting that interventions in this age group could be impactful in preventing GAS disease. It will be important to monitor GAS carriage and disease in these communities over time, particularly as vaccines become available.

Author Contributions

Conceptualization, methodology, supervision, C.G.S. and L.L.H.; funding acquisition, C.G.S., S.C., L.M. and L.L.H.; data curation, formal analysis, V.M.S.; investigation, J.P., C.H., Z.L. and S.M.; project administration, R.W.; resources, S.C., C.J.G., L.M. and J.O.O.; writing—original draft preparation, C.G.S., V.M.S. and L.L.H.; writing—review and editing, S.C., C.J.G., C.H., Z.L., S.M., L.M., J.O.O., J.P., T.T. and R.W. All authors have read and agreed to the published version of the manuscript.

Funding

This work was funded by the Centers for Disease Control and Prevention through a Broad Agency Announcement (75D30122C15561 to C.G.S.). The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Indian Health Service.

Institutional Review Board Statement

The studies were conducted in accordance with the Declaration of Helsinki, and approved by the White Mountain Apache Tribe, the Navajo Nation Human Research Review Board (NNR-07.216, 19 September 2017; NNR-22.448, 19 July 2022), and the Institutional Review Boards of the Phoenix Area Indian Health Service (PXR 17.08, 31 January 2018; PXR 23.01, 8 January 2024) and Johns Hopkins Bloomberg School of Public Health (#8170, 7 September 2017; #24071, 28 February 2023).

Informed Consent Statement

Written informed consent was obtained from all participants involved in the carriage studies.

Data Availability Statement

Participant data collected on Tribal lands are owned by the participating Tribal Nations. Data can be made available upon request to the corresponding author (contact csutcli1@jhu.edu) if consistent with the Institutional Review Board–approved protocol and if the disclosure is approved by the participating Tribes and the Centers for Disease Control and Prevention.

Conflicts of Interest

Z.L. and S.M. are employed by ASRT Inc. The authors declare no conflicts of interest.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Sutcliffe, C.G.; Sergent, V.M.; Pitalua, J.; Chochua, S.; Gregory, C.J.; Hurley, C.; Li, Z.; Mathis, S.; McGee, L.; Okaro, J.O.; et al. Prevalence, Risk Factors, and Strain Distribution of Group A Streptococcus Carriage Among Indigenous Children in the Southwest United States. Proceedings 2025, 124, 12. https://doi.org/10.3390/proceedings2025124012

AMA Style

Sutcliffe CG, Sergent VM, Pitalua J, Chochua S, Gregory CJ, Hurley C, Li Z, Mathis S, McGee L, Okaro JO, et al. Prevalence, Risk Factors, and Strain Distribution of Group A Streptococcus Carriage Among Indigenous Children in the Southwest United States. Proceedings. 2025; 124(1):12. https://doi.org/10.3390/proceedings2025124012

Chicago/Turabian Style

Sutcliffe, Catherine G., Victoria M. Sergent, Joyselynn Pitalua, Sopio Chochua, Christopher J. Gregory, Chloe Hurley, Zhongya Li, Saundra Mathis, Lesley McGee, Jennifer Onukwube Okaro, and et al. 2025. "Prevalence, Risk Factors, and Strain Distribution of Group A Streptococcus Carriage Among Indigenous Children in the Southwest United States" Proceedings 124, no. 1: 12. https://doi.org/10.3390/proceedings2025124012

APA Style

Sutcliffe, C. G., Sergent, V. M., Pitalua, J., Chochua, S., Gregory, C. J., Hurley, C., Li, Z., Mathis, S., McGee, L., Okaro, J. O., Tran, T., Weatherholtz, R., & Hammitt, L. L. (2025). Prevalence, Risk Factors, and Strain Distribution of Group A Streptococcus Carriage Among Indigenous Children in the Southwest United States. Proceedings, 124(1), 12. https://doi.org/10.3390/proceedings2025124012

Article Metrics

Back to TopTop