Carriage Rate of Neisseria meningitidis, Antibiotic Susceptibility Pattern and Associated Risk Factors among Primary School Children in Gondar town, Northwest Ethiopia

Abstract

Background Invasive meningococcal disease has 70–80% mortality. Globally, 1.2 million estimated cases were reported with ~135,000 deaths annually. In African meningitis belt bacterial meningitis remains a serious threat to health accounting an estimated 500,000 cases of invasive meningococcal disease annually.In Ethiopia, specifically in our study area, limited information is found on the oropharyngeal carriage, antimicrobial resistance pattern and associated risk factors for N. meningitidis especially in school children. So, the aim of this study was to assess oropharyngeal carriage rate of N. meningitidis, antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia. Methods A cross sectional prospective study was conducted from January-April, 2019 among primary school children. Multi stage simple random sampling technique was used. A total of 524 oropharyngeal swabs were collected using sterile plastic cotton swabs. Modified Thayer Martin media was used for primary inoculation. Antimicrobial susceptibility pattern was done on Muller-Hinton agar supplemented with 5% sheep blood. Logistic regression model was used to see the association between dependent and independent variables. P ≤0.05 at 95% CI was considered as statistically significant. Results A total of 53(10.1%) (CI: 7.6-12.8) N. meningitidis isolates were identified. Serogroup A 13 (24.5%) was the most prevalent followed by Y/W135 11(20.7%) whereas serogroup B 4(7.6%) was the least identified. Meningococcal isolates were resistant to ciprofloxacin (45.3%) and trimethoprim-sulfamethoxazole (73.6%). Overall, most of meningococcal isolates showed high level of multidrug resistance with the rate of 32(60.4%). Meningococcal carriage rate was associated with family size, tonsillectomy, passive smoking, number of students per class, sharing utensils, history of visiting healthcare institutions and indoor kitchen. Conclusion Neisseria meningitidis prevalence in the present study was high. Serogroup A and W135/Y was the most prevalent isolate. High multidrug resistance pattern was observed.

Prevalence and persistence of Neisseria meningitidis carriage in Swedish university students

“…However, alcohol drinking and party attendance often occur simultaneously, making the causal relationship with carriage hard to assess. Previous tonsillectomy has been associated with higher carriage rates of N. meningitidis in other studies [31, 32], and this association was also seen in the present study. We studied one possible risk factor for meningococcal carriage that has been only sparsely studied before: the use of Swedish snus.…”

Asymptomatic nasopharyngeal bacterial carriage, multi-drug resistance pattern and associated factors among primary school children at Debre Berhan town, North Shewa, Ethiopia

“…Another independently associated factor statically associated with nasopharyngeal bacteria carriage was children with a history of hospitalization [AOR=4.08, 95%CI 1.45–1.53, P=0.008]. This is in agreement with the studies conducted in Ethiopia, Hawassa (p=0.00) [ 55 ], Gondar (P= 0.031) [ 71 ]. Common type of nosocomial infection involves invasive devices and procedures (urinary catheters, central lines, mechanical ventilation, or surgery) which might be an important factor for the transmission of respiratory infections and it could have a role in bacteria carriage for healthy individuals [ 72 ].…”

“…In the present study participants who had large family-size showed statistically significant association with the occurrence of with nasopharyngeal bacteria carriage [AOR=2.17, 95%CI 1.24–3.81, P=0.006], which is comparable with studies reported in Indian (P = 0.03)[ 70 ], Iran (p=0.044) [ 62 ], Ethiopia in Addis Ababa (p=0.006) [ 7 ], and Gondar (P= 0.031) [ 71 ]. The other factor in the present study that has statically significant association was numbers of rooms (1-2) per house with [AOR=5.88, 95%CI: 1.26-27.57, P=0.024].…”