Meningococcal carriage within households in the african meningitis belt: a longitudinal pilot study.


Basta, NE; Berthe, A; Keita, M; Onwuchekwa, U; Tamboura, B; Traore, A; Hassan-King, M; Manigart, O; Nascimento, M; Stuart, JM; Trotter, C; Blake, J; Carr, AD; Gray, SJ; Newbold, LS; Deng, Y; Wolfson, J; Halloran, ME; Greenwood, B; Borrow, R; Sow, SO; (2017) Meningococcal carriage within households in the african meningitis belt: a longitudinal pilot study. The Journal of infection. ISSN 0163-4453 DOI: https://doi.org/10.1016/j.jinf.2017.11.006

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Abstract

Carriers of Neisseria meningitidis are a key source of transmission. In the African meningitis belt, where risk of meningococcal disease is highest, a greater understanding of meningococcal carriage dynamics is needed. We randomly selected an age-stratified sample of 400 residents from 116 households in Bamako, Mali, and collected pharyngeal swabs in May 2010. A month later, we enrolled all 202 residents of 20 of these households (6 with known carriers) and collected swabs monthly for 6 months prior to MenAfriVac vaccine introduction and returned 10 months later to collect swabs monthly for 3 months. We used standard bacteriological methods to identify N. meningitidis carriers and fit hidden Markov models to assess acquisition and clearance overall and by sex and age. During the cross-sectional study 5.0% of individuals (20/400) were carriers. During the longitudinal study, 73 carriage events were identified from 1,422 swabs analyzed and 16.3% of individuals (33/202) were identified as carriers at least once. The vast majority of isolates were non-groupable; no serogroup A carriers were identified. Our results suggest that the duration of carriage with any N. meningitidis averages 2.9 months and that males and children acquire and lose carriage more frequently in an urban, low-resource setting in Mali. Our study informed the design of a larger study across seven countries of the meningitis belt.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Antimicrobial Resistance Centre (AMR)
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PubMed ID: 29197599
Web of Science ID: 425352300004
URI: http://researchonline.lshtm.ac.uk/id/eprint/4645568

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