The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine.


MenAfriCar consortium; , COLLABORATORS; Ali, O; Aseffa, A; Bedru, A; Lema, T; Moti, T; Tekletsion, Y; Worku, A; Xabher, HG; Yamuah, L; Boukary, RM; Collard, JM; Dano, ID; Habiboulaye, I; Issaka, B; Jusot, JF; Ousmane, S; Rabe, I; Daugla, DM; Gami, JP; Gamougam, K; Mbainadji, L; Naibei, N; Narbé, M; Toralta, J; Berthe, A; Diallo, K; Keita, M; Onwuchekwa, U; Sow, SO; Tamboura, B; Traore, A; Toure, A; Clark, T; Mayer, L; Amodu, M; Beida, O; Gadzama, G; Omotara, B; Sambo, Z; Yahya, S; Chandramohan, D; Greenwood, BM; Hassan-King, M; Manigart, O; Nascimento, M; Stuart, JM; Woukeu, A; Basta, NE; Bai, X; Borrow, R; Findlow, H; Alavo, S; Bassene, H; Diallo, A; Dieng, M; Doucouré, S; Gomis, JF; Ndiaye, A; Sokhna, C; Trape, JF; Akalifa, B; Forgor, A; Hodgson, A; Osei, I; Quaye, SL; Williams, J; Wontuo, P; Irving, T; Trotter, CL; Bennett, J; Hill, D; Harrison, O; Maiden, MC; Rebbetts, L; Watkins, E; (2015) The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine. The Journal of infectious diseases, 212 (8). pp. 1298-307. ISSN 0022-1899 DOI: 10.1093/infdis/jiv211

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Abstract

Study of meningococcal carriage is essential to understanding the epidemiology of Neisseria meningitidis infection. Twenty cross-sectional carriage surveys were conducted in 7 countries in the African meningitis belt; 5 surveys were conducted after introduction of a new serogroup A meningococcal conjugate vaccine (MenAfriVac). Pharyngeal swab specimens were collected, and Neisseria species were identified by microbiological and molecular techniques. A total of 1687 of 48 490 participants (3.4%; 95% confidence interval [CI], 3.2%-3.6%) carried meningococci. Carriage was more frequent in individuals aged 5-14 years, relative to those aged 15-29 years (adjusted odds ratio [OR], 1.41; 95% CI, 1.25-1.60); in males, relative to females (adjusted OR, 1.17; 95% CI, 1.10-1.24); in individuals in rural areas, relative to those in urban areas (adjusted OR, 1.44; 95% CI, 1.28-1.63); and in the dry season, relative to the rainy season (adjusted OR, 1.54; 95% CI, 1.37-1.75). Forty-eight percent of isolates had genes encoding disease-associated polysaccharide capsules; genogroup W predominated, and genogroup A was rare. Strain diversity was lower in countries in the center of the meningitis belt than in Senegal or Ethiopia. The prevalence of genogroup A fell from 0.7% to 0.02% in Chad following mass vaccination with MenAfriVac. The prevalence of meningococcal carriage in the African meningitis belt is lower than in industrialized countries and is very diverse and dynamic, even in the absence of vaccination.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Vaccine Centre
PubMed ID: 25858956
Web of Science ID: 363195400017
URI: http://researchonline.lshtm.ac.uk/id/eprint/2318891

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