Ed Monk PhD Upgrading Seminar - 3/11/25

Ed Monk's PhD upgrading seminar on 'The transmissions dynamics of Streptococcus pyogenes within the classrooms. households and environment of primary school-aged children in The Gambia' will be taking place on Monday the 3rd of November 2025, at 13:00 GMT.

Please join over Zoom

Meeting ID: 874 0545 6592

Password: 174366

Abstract

This PhD will investigate the transmission of Streptococcus pyogenes (Strep A) in primary school-aged children and their household members in Bakau, the Gambia. Based at a single school site, StrepCATCHERS (this PhD’s main study) is a prospective cohort of approximately 120 pupils aged 4-12 years, running alongside an ongoing project exploring the immune response to Strep A infection (iSpySchool). 

Participants will be screened and sampled from their classrooms for Strep A pharyngitis, pyoderma and pharyngeal/skin asymptomatic carriage over a 6-month period. When a case of Strep A pharyngitis or pyoderma is detected through real-time quantitative polymerase chain reaction (qPCR), a reactive survey will be conducted in the classroom and the household of the index case to monitor for transmission. 

The primary objectives of StrepCATCHERS are:

1)    To establish an accurate incidence of pharyngitis, pyoderma and asymptomatic pharyngeal/skin carriage of Strep A in primary school-aged children in The Gambia.

2)    To calculate the secondary attack rate (SAR) of Strep A infection and carriage, through temporal and genomic linkage, in classmates and household members of index cases of pharyngitis and pyoderma.

3)    To investigate whether bacterial load in the pharynx or skin/wounds is a driver of onward transmission and environmental detection, and whether this is different between symptomatic and asymptomatic cases.

The real-time molecular testing (qPCR) methods and linked classroom-household sampling frame utilised by StrepCATCHERS will allow the reconstruction of Strep A transmission chains to a granularity not achieved to date. Its study design will also allow for rates of onwards transmission to be considered in relation to bacterial load, which has not been investigated previously. These novel insights into Strep A transmission in a high burden population and setting will provide the opportunity to produce essential parameters for further modelling and Strep A intervention planning, including vaccines which are under development.