Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci


Dellicour, S; Greenwood, B; (2007) Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci. Tropical medicine & international health , 12 (12). pp. 1409-1421. ISSN 1360-2276 DOI: 10.1111/j.1365-3156.2007.01929.x

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Abstract

OBJECTIVE To investigate the effect of meningococcal vaccines on pharyngeal carriage of meningococci. METHODS Systematic review. MEDLINE and EMBASE were searched for relevant studies. Controlled trials and observational studies which used comparison groups or compared carriage rates before and after vaccination were included in the review. RESULTS Twenty-nine studies satisfied the inclusion criteria. Twenty-five studies reported the effect of a polysaccharide vaccine, one the effect of a serogroup C conjugate vaccine and three the impact of serogroup B outer-membrane vaccines on overall and/or serogroup-specific meningococcal carriage rates. Ten studies of meningococcal polysaccharide vaccines found reduced serogroup-specific carriage; seven of these focussed on high-risk groups and had a short follow-up period. Only one of five studies of civilian populations in Africa showed a significantly reduced carriage. Many studies had methodological shortcomings. The one study which assessed the effect of a meningococcal conjugate vaccine on carriage showed a significant impact. Three studies of serogroup B outer-membrane protein vaccines showed no effect on carriage. CONCLUSIONS A few well-designed trials of the impact of meningococcal vaccines on carriage have been undertaken. Such studies should be an essential component of the evaluation of new meningococcal vaccines, particularly those introduced to control epidemic meningococcal disease in Africa.

Item Type: Article
Keywords: Carrier State, drug therapy, prevention & control, Humans, Immunization Programs, organization & administration, statistics & numerical data, Meningitis, Meningococcal, immunology, prevention & control, Meningococcal Vaccines, therapeutic use, Pharynx, microbiology, Randomized Controlled Trials as Topic
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Vaccine Centre
PubMed ID: 17961128
Web of Science ID: 251387300002
URI: http://researchonline.lshtm.ac.uk/id/eprint/7925

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