Asymptomatic Carriage, Knowledge, and Risk factors Associated with Streptococcus Pneumoniae Infection Among Public Transport Users (Taxi-Bus) in Franceville, South-East Gabon

Background: Despite the existence of a vaccine, pneumococcal bacteria remain a major health problem, particularly in Africa, where they cause many deaths, especially among young children and the elderly. The present study looked at asymptomatic carriage, knowledge and risk factors associated with Streptococcus pneumoniae infection, among public transport users (Taxis-Bus) in Franceville, south-east Gabon. Materials and Methods: This prospective cross-sectional study conducted from April 19 to July 23, 2024 on 241 adults, analyzed their sputum samples for Streptococcus pneumoniae bacteria by culture on nutrient agar supplemented with 5-10% defibrinated sheep blood. Suspect colonies were identified by a biochemical optochin sensitivity test. Factors increasing the risk of carrying the bacteria were identified by statistical analysis, including bivariate analysis and multivariate logistic regression. Within a 95% confidence interval, all p ≤0.05 were considered statistically significant. Results: A total of 241 users of public transport in Franceville, commonly known as “Taxis-Bus”, with a mean age of 37 ± 13.75 years, were registered for the present study. The overall prevalence of Streptococcus pneumoniae infection was 24.5% (95% CI: [0.19- 0.30]). Male gender (adjusted Odds Ratio = 2.88; 95% CI [1.69 ;4.92], p≤0.001*), age group 60 and over (adjusted Odds Ratio = 2.12; 95% CI [1,3 ;1.42], p=0.032*), regular taxi-bus use (adjusted Odds Ratio = 2.22; 95% CI [1.27 ; 3.88], p= 0.045*), not being vaccinated (Adjusted Odds Ratio = 2.78; 95% CI [1.6 ; 4.1 p=0.041*), and smoking (Adjusted Odds Ratio = 5.23; 95% CI [2.77 ; 9.85] ; p=0.012*), significantly exposed study participants to Streptococcus pneumoniae infection. Conclusion: The results obtained in the present study underline the importance of pneumococcal vaccination, particularly for the most vulnerable people such as men, the elderly and smokers. They also highlight the need for preventive measures on public transport to limit the spread of the bacterium.