Observational studyThe Journal of infectious diseases2025
Household Molecular Epidemiology of Streptococcus pyogenes Carriage and Infection in The Gambia.
Observational study in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05117528 (Streptococcus Pyogenes Carriage Acquisition, Persistence and Transmission Dynamics Within Households in The Gambia), which is not on this map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Streptococcus Pyogenes Carriage Acquisition, Persistence and Transmission Dynamics Within Households in The Gambia: a Longitudinal Cohort Study
Who cites it
3 citing papers in PubMed.
- Acute rheumatic fever and rheumatic heart disease.Nature reviews. Disease primers · 2026Review
- Beyond theMicrobiology spectrum · 2026Article
- Early-life serological profiles and the development of natural protective humoral immunity to Streptococcus pyogenes in a high-burden setting.Nature medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
Abstract
backgroundAfrica experiences a high burden of Streptococcus pyogenes disease but has limited epidemiological data. We characterized emm types and emm clusters associated with carriage and disease in The Gambia, a setting with a high rheumatic heart disease burden.
methodsA 1-year household cohort study (2021-2022) recruited 442 participants from 44 households to assess S. pyogenes carriage and noninvasive infection. Pharyngeal and skin swab samples were collected to detect carriage, and pharyngitis and pyoderma swab samples were taken to assess infection. Cultured isolates underwent emm typing and were compared with previous collection from the same region.
resultsA total of 221 cultured isolates showed 52 different emm types and 16 emm clusters. Strain diversity was high (Simpson reciprocal index, 29.3 [95% confidence interval, 24.8-36.0]), with the highest diversity seen in pyoderma and the lowest in pharyngitis. Based on available cross-opsonization data, the 30-valent M-protein vaccine candidate would cover 50.8% of the isolates, but cross-opsonization data are unknown for 38.5% of them. The emm clusters showed lower diversity and were stable over time, with 4 clusters defining 65.2% of the isolates; 68% of isolates were collected from skin sites (carriage and pyoderma), with evidence of skin-to-throat transmission in the same host.
conclusionsThis study provides a unique molecular analysis of skin and throat isolates prospectively collected from persons with carriage and noninvasive infection in Africa. Despite high strain diversity, 4 clusters included two-thirds of the isolates, representing antigen priorities for broad vaccine coverage. In this rheumatic fever-endemic setting, pyoderma and skin carriage represent an important S. pyogenes reservoir and should be included in further surveillance studies and public health interventions. CLINICAL TRIALS REGISTRATION: NCT05117528.
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Registered trials
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