Risk factors for acquisition of meningococcal carriage in the African meningitis belt.

Cooper, Laura V; Robson, Anna; Trotter, Caroline L; Aseffa, Abraham; Collard, Jean-Marc; Daugla, Doumagoum Moto; Diallo, Aldiouma; Hodgson, Abraham; Jusot, Jean-François; Omotara, Babatunji; +11 more...Sow, Samba; Hassan-King, Musa; Manigart, OlivierORCID logo; Nascimento, Maria; Woukeu, Arouna; Chandramohan, DanielORCID logo; Borrow, Ray; Maiden, Martin CJ; Greenwood, BrianORCID logo; Stuart, James M; and MenAfriCar Consortium (2019) Risk factors for acquisition of meningococcal carriage in the African meningitis belt. TROPICAL MEDICINE & INTERNATIONAL HEALTH, 24 (4). pp. 392-400. ISSN 1360-2276 DOI: 10.1111/tmi.13203
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OBJECTIVE: To investigate potential risk factors for acquisition in seven countries of the meningitis belt. METHODS: Households were followed up every 2 weeks for 2 months, then monthly for a further 4 months. Pharyngeal swabs were collected from all available household members at each visit and questionnaires completed. Risks of acquisition over the whole study period and for each visit were analysed by a series of logistic regressions. RESULTS: Over the course of the study, acquisition was higher in: (i) 5-to 14-year olds, as compared with those 30 years or older (OR 3.6, 95% CI 1.4-9.9); (ii) smokers (OR 3.6, 95% CI 0.98-13); and (iii) those exposed to wood smoke at home (OR 2.6 95% CI 1.3-5.6). The risk of acquisition from one visit to the next was higher in those reporting a sore throat during the dry season (OR 3.7, 95% CI 2.0-6.7) and lower in those reporting antibiotic use (OR 0.17, 95% CI 0.03-0.56). CONCLUSIONS: Acquisition of meningococcal carriage peaked in school age children. Recent symptoms of sore throat during the dry season, but not during the rainy season, were associated with a higher risk of acquisition. Upper respiratory tract infections may be an important driver of epidemics in the meningitis belt.


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