The diversity of meningococcal carriage across the African meningitis belt and the impact of vaccination with a group a meningococcal conjugate vaccine

Oumer Ali, Abraham Aseffa, Ahmed Bedru, Tsehaynesh Lema, Tesfaye Moti, Yenenesh Tekletsion, Alemayehu Worku, Haimanot Guebre Xabher, Lawrence Yamuah, Rahamatou Moustapha Boukary, Jean Marc Collard, Ibrahim Dan Dano, Ibrahim Habiboulaye, Bassira Issaka, Jean François Jusot, Sani Ousmane, Issoufa Rabe, Doumagoum Moto Daugla, Jean Pierre Gami, Kadidja GamougamLodoum Mbainadji, Nathan Naibei, Maxime Narbé, Jacques Toralta, Abdoulaye Berthe, Kanny Diallo, Mahamadou Keita, Uma Onwuchekwa, Samba O. Sow, Boubou Tamboura, Awa Traore, Alou Toure, Tom Clark, Leonard Mayer, Mary Amodu, Omeiza Beida, Galadima Gadzama, Babatunji Omotara, Zailani Sambo, Shuaibu Yahya, Daniel Chandramohan, Brian M. Greenwood, Musa Hassan-King, Olivier Manigart, Maria Nascimento, James M. Stuart, Arouna Woukeu, Nicole E. Basta, Xilian Bai, Ray Borrow, Helen Findlow, Serge Alavo, Hubert Bassene, Aldiouma Diallo, Marietou Dieng, Souleymane Doucouré, Jules François Gomis, Assane Ndiaye, Cheikh Sokhna, Jean François Trape, Bugri Akalifa, Abudulai Forgor, Abraham Hodgson, Isaac Osei, Stephen L. Quaye, John Williams, Peter Wontuo, Thomas Irving, Caroline L. Trotter, Julia Bennett, Dorothea Hill, Odile Harrison, Martin C. Maiden, Lisa Rebbetts, Eleanor Watkins

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Background.Study of meningococcal carriage is essential to understanding the epidemiology of Neisseria meningitidis infection. Methods.Twenty cross-sectional carriage surveys were conducted in 7 countries in the African meningitis belt; 5 surveys were conducted after introduction of a new serogroup A meningococcal conjugate vaccine (MenAfriVac). Pharyngeal swab specimens were collected, and Neisseria species were identified by microbiological and molecular techniques. Results.A total of 1687 of 48 490 participants (3.4%; 95% confidence interval [CI], 3.2%-3.6%) carried meningococci. Carriage was more frequent in individuals aged 5-14 years, relative to those aged 15-29 years (adjusted odds ratio [OR], 1.41; 95% CI, 1.25-1.60); in males, relative to females (adjusted OR, 1.17; 95% CI, 1.10-1.24); in individuals in rural areas, relative to those in urban areas (adjusted OR, 1.44; 95% CI, 1.28-1.63); and in the dry season, relative to the rainy season (adjusted OR, 1.54; 95% CI, 1.37-1.75). Forty-eight percent of isolates had genes encoding disease-associated polysaccharide capsules; genogroup W predominated, and genogroup A was rare. Strain diversity was lower in countries in the center of the meningitis belt than in Senegal or Ethiopia. The prevalence of genogroup A fell from 0.7% to 0.02% in Chad following mass vaccination with MenAfriVac. Conclusions.The prevalence of meningococcal carriage in the African meningitis belt is lower than in industrialized countries and is very diverse and dynamic, even in the absence of vaccination.

Original languageEnglish (US)
Pages (from-to)1298-1307
Number of pages10
JournalJournal of Infectious Diseases
Issue number8
StatePublished - Oct 15 2015

Bibliographical note

Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.


  • Africa
  • Neisseria meningitidis
  • carriage
  • meningitis
  • meningococcus


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