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, Ray BorrowSamba O. Sow

Research output: Contribution to journalArticle

3 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 (US)
Pages (from-to)140-148
Number of pages9
JournalJournal of Infection
Volume76
Issue number2
DOIs
StatePublished - Feb 2018

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Neisseria meningitidis
Meningitis
Mali
Longitudinal Studies
Vaccines
Cross-Sectional Studies

Keywords

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

Cite this

Meningococcal carriage within households in the African meningitis belt : A longitudinal pilot study. / Basta, Nicole E.; Berthe, Abdoulaye; Keita, Mahamadou; Onwuchekwa, Uma; Tamboura, Boubou; Traore, Awa; Hassan-King, Musa; Manigart, Olivier; Nascimento, Maria; Stuart, James M.; Trotter, Caroline; Blake, Jayne; Carr, Anthony D.; Gray, Stephen J.; Newbold, Lynne S.; Deng, Yangqing; Wolfson, Julian; Halloran, M. Elizabeth; Greenwood, Brian; Borrow, Ray; Sow, Samba O.

In: Journal of Infection, Vol. 76, No. 2, 02.2018, p. 140-148.

Research output: Contribution to journalArticle

Basta, NE, Berthe, A, Keita, M, Onwuchekwa, U, Tamboura, B, Traore, A, Hassan-King, M, Manigart, O, Nascimento, M, Stuart, JM, Trotter, C, Blake, J, Carr, AD, Gray, SJ, Newbold, LS, Deng, Y, Wolfson, J, Halloran, ME, Greenwood, B, Borrow, R & Sow, SO 2018, 'Meningococcal carriage within households in the African meningitis belt: A longitudinal pilot study', Journal of Infection, vol. 76, no. 2, pp. 140-148. https://doi.org/10.1016/j.jinf.2017.11.006
Basta, Nicole E. ; Berthe, Abdoulaye ; Keita, Mahamadou ; Onwuchekwa, Uma ; Tamboura, Boubou ; Traore, Awa ; Hassan-King, Musa ; Manigart, Olivier ; Nascimento, Maria ; Stuart, James M. ; Trotter, Caroline ; Blake, Jayne ; Carr, Anthony D. ; Gray, Stephen J. ; Newbold, Lynne S. ; Deng, Yangqing ; Wolfson, Julian ; Halloran, M. Elizabeth ; Greenwood, Brian ; Borrow, Ray ; Sow, Samba O. / Meningococcal carriage within households in the African meningitis belt : A longitudinal pilot study. In: Journal of Infection. 2018 ; Vol. 76, No. 2. pp. 140-148.
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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.",
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T1 - Meningococcal carriage within households in the African meningitis belt

T2 - A longitudinal pilot study

AU - Basta, Nicole E.

AU - Berthe, Abdoulaye

AU - Keita, Mahamadou

AU - Onwuchekwa, Uma

AU - Tamboura, Boubou

AU - Traore, Awa

AU - Hassan-King, Musa

AU - Manigart, Olivier

AU - Nascimento, Maria

AU - Stuart, James M.

AU - Trotter, Caroline

AU - Blake, Jayne

AU - Carr, Anthony D.

AU - Gray, Stephen J.

AU - Newbold, Lynne S.

AU - Deng, Yangqing

AU - Wolfson, Julian

AU - Halloran, M. Elizabeth

AU - Greenwood, Brian

AU - Borrow, Ray

AU - Sow, Samba O.

PY - 2018/2

Y1 - 2018/2

N2 - 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.

AB - 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.

KW - Africa

KW - Bacterial Meningitis

KW - Carriers

KW - Epidemiology

KW - Mali

KW - Meningococcal disease

KW - Neisseria meningitidis

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