Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt

Basta, Nicole E.; Stuart, James M.; Nascimento, Maria Cláudia; Manigart, Olivier; Trotter, Caroline; Hassan-King, Musa; Chandramohan, Daniel; Sow, Samba O.; Berthe, Abdoulaye; Bedru, Ahmed; Collard, Jean-Marc; Jusot, Jean François; Diallo, Aldiouma; Basséne, Hubert; Daugla, Doumagoum Moto; Gamougam, Khadidja; Hodgson, Abraham; Forgor, Abudulai Adams; Omotara, Babatunji A.; Gadzama, Galadima; Watkins, Eleanor; Rebbetts, Lisa S.; Diallo, Kanny; Weiss, Noel S.; Halloran, M. Elizabeth; Maiden, Martin C. J.; Greenwood, Brian

doi:10.1371/journal.pone.0078336

Cited by 18 publications

(24 citation statements)

References 25 publications

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“…The prevalence of N. meningitidis in our study had a high carriage rate than three studies conducted in Mali, with oropharyngeal carriage of 5%, 7.7%, and 6.9% [11,26,27] respectively. The predominant serogroup was none-serogroupabable and serogroup A was not identified.…”

Section: Discussioncontrasting

confidence: 53%

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

Tefera¹,

Mekonnen

Tiruneh

et al. 2019

Preprint

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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.

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Section: Discussioncontrasting

confidence: 53%

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

Tefera¹,

Mekonnen

Tiruneh

et al. 2019

Preprint

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“…Regarding the sampling methods throat sampling is clearly the sampling method of choice, which is consistent with previous studies . In addition, sensitivity can be improved by using PCR, which is more sensitive than culture for identification of asymptomatic carriers .…”

Section: Discussionsupporting

confidence: 84%

Neisseria meningitidis carriage in Swedish teenagers associated with the serogroup W outbreak at the World Scout Jamboree, Japan 2015

Jacobsson

Stenmark

Hedberg

et al. 2018

APMIS

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Jacobsson S, Stenmark B, Hedberg ST, M€ olling P, Fredlund H. Neisseria meningitidis carriage in Swedish teenagers associated with the serogroup W outbreak at the World Scout Jamboree, Japan 2015. APMIS 2018; 126: 337-341.The aims of the study were to estimate the carrier state of Neisseria meningitidis in Swedish teenagers and its association with an outbreak at the World Scout Jamboree in 2015 as well as to compare sensitivity of throat versus nasopharyngeal swab for optimal detection of carriage. In total, 1 705 samples (cultures n = 32, throat swabs n = 715, nasopharyngeal swabs n = 958) from 1 020 Jamboree participants were collected and sent to the National Reference Laboratory for Neisseria meningitidis for culture and molecular analysis. The overall positivity for N. meningitidis was 8% (83/1 020), whereas 2% (n = 22) belonged to a known sero/genogroup while the majority (n = 61) were non-groupable. Throat sample is clearly the sampling method of choice, in 56 individuals where both throat and nasopharynx samples were taken, N. meningitidis was detected in both throat and nasopharynx in eight individuals, in 46 individuals N. meningitidis was only detected in the throat and in two individuals only in the nasopharynx. Carriage studies are important to provide knowledge of the current epidemiology and association between carrier isolates and disease-causing isolates in a given population. Therefore, planning for a carriage study in Sweden is in progress.

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“…Among studies that used the oropharyngeal approach, swabbing of solely the posterior pharyngeal wall was used in two studies whilst in the remainder both the posterior pharynx and the tonsils were swabbed. A comparative study conducted in Mali showed no significant difference in the prevalence of pharyngeal carriage of N. meningitidis using either of these two methods .…”

Section: Resultsmentioning

confidence: 96%

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Greenwood

Aseffa

Caugant

et al. 2018

Tropical Med Int Health

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Objective To review the findings of studies of pharyngeal carriage of Neisseria meningitidis and related species conducted in the African meningitis belt since a previous review published in 2007. Methods PubMed and Web of Science were searched in July 2018 using the terms ‘meningococcal OR Neisseria meningitidis OR lactamica AND carriage AND Africa’, with the search limited to papers published on or after 1st January 2007. We conducted a narrative review of these publications. Results One hundred and thirteen papers were identified using the search terms described above, 20 of which reported new data from surveys conducted in an African meningitis belt country. These papers described 40 surveys conducted before the introduction of the group A meningococcal conjugate vaccine (MenAfriVacR) during which 66 707 pharyngeal swabs were obtained. Carriage prevalence of N. meningitidis varied substantially by time and place, ranging from <1% to 24%. The mean pharyngeal carriage prevalence of N. meningitidis across all surveys was 4.5% [95% CI: 3.4%, 6.8%] and that of capsulated N. meningitidis was 2.8% [95% CI: 1.9%; 5.2%]. A study of households provided strong evidence for meningococcal transmission within and outside households. The introduction of MenAfriVac® led to marked reductions in carriage of the serogroup A meningococcus in Burkina Faso and Chad. Conclusions Recent studies employing standardised methods confirm the findings of older studies that carriage of N. meningitidis in the African meningitis belt is highly variable over time and place, but generally occurs with a lower prevalence and shorter duration than reported from industrialised countries.

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Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt

Cited by 18 publications

References 25 publications

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

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

Neisseria meningitidis carriage in Swedish teenagers associated with the serogroup W outbreak at the World Scout Jamboree, Japan 2015

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

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