Meningococcal carriage within households in the African meningitis belt: A longitudinal pilot study

Nicole E. Basta*, Abdoulaye Berthe, Mahamadou Keita, Uma Onwuchekwa, Boubou Tamboura, Awa Traore, Musa Hassan-King, Olivier Manigart, Maria Nascimento, James M. Stuart, Caroline Trotter, Jayne Blake, Anthony D. Carr, Stephen J. Gray, Lynne S. Newbold, Yangqing Deng, Julian Wolfson, M. Elizabeth Halloran, Brian Greenwood, Raymond BorrowSamba O. Sow

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objectives: 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. Methods: 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. Results: During the cross-sectional study 5.0% of individuals (20/400) were carriers. During the longitudinal study, 73 carriage events were identified from 1422 swabs analyzed, and 16.3% of individuals (33/202) were identified as carriers at least once. The majority of isolates were non-groupable; no serogroup A carriers were identified. Conclusions: 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 setting in Mali. Our study informed the design of a larger study implemented in seven countries of the African meningitis belt.

Original languageEnglish
Pages (from-to)140-148
Number of pages9
JournalJournal of Infection
Volume76
Issue number2
DOIs
Publication statusPublished - Feb 2018

Bibliographical note

Funding Information:
This research was funded by the Bill & Melinda Gates Foundation Grant 51251 (www.gatesfoundation.org), the Wellcome Trust Grant 086546 (www.wellcome.ac.uk), the US National Institutes of Health (NIH) grant R03AI092121, and the NIH Early Independence Award grant 1DP5OD009162 (Office of the Director and the National Institute of Dental and Craniofacial Research) (www.nih.gov). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Funding Information:
This research was funded by the Bill & Melinda Gates Foundation Grant 51251 ( www.gatesfoundation.org ), the Wellcome Trust Grant 086546 ( www.wellcome.ac.uk ), the US National Institutes of Health (NIH) grant R03AI092121 , and the NIH Early Independence Award grant 1DP5OD009162 (Office of the Director and the National Institute of Dental and Craniofacial Research) ( www.nih.gov ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Publisher Copyright:
© 2017 The Authors

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Africa
  • Bacterial Meningitis
  • Carriers
  • Epidemiology
  • Mali
  • Meningococcal disease
  • Neisseria meningitidis

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