The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine.
The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine.
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DOI：
10.1093/infdis/jiv211
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发表时间：
2015-10-15
期刊：
影响因子：
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通讯作者：
MenAfriCar consortium
中科院分区：
文献类型：
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作者：
MenAfriCar consortium
背景：脑膜炎球菌携带的研究对于了解脑膜炎奈瑟菌感染的流行病学是必不可少的。 方法：在非洲脑膜炎带的7个国家进行了20次横断面携带调查; 5次调查是在引入新的血清群A脑膜炎球菌结合疫苗（MenAfriVac）后进行的。 采集咽拭子标本，通过微生物学和分子生物学技术鉴定奈瑟菌属。结果：48490名参与者中共有1687名（3.4%; 95%可信区间[CI]，3.2%-3.6%）携带脑膜炎双球菌。 相对于15-29岁的人，5-14岁的人携带更频繁（校正比值比[OR]，1.41; 95% CI，1.25-1.60）;男性相对于女性（调整OR，1.17; 95% CI，1.10-1.24）;农村地区个体相对于城市地区个体（调整后OR，1.44; 95%CI，1.28-1.63）;在旱季，相对于雨季（调整后OR，1.54; 95%CI，1.37-1.75）。48%的菌株具有编码疾病相关多糖荚膜的基因;基因组W占主导地位，基因组A很少见。脑膜炎带中心国家的菌株多样性低于塞内加尔或埃塞俄比亚。在乍得，大规模接种MenAfriVac疫苗后，A基因组的患病率从0.7%降至0.02%。结论：在非洲脑膜炎地带，脑膜炎球菌携带的流行率低于工业化国家，即使在没有接种疫苗的情况下，也是非常多样化和动态的。
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.