Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt
Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt
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DOI：
10.1371/journal.pone.0078336
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发表时间：
2013-10-23
期刊：
影响因子：
3.7
通讯作者：
Greenwood, Brian
中科院分区：
文献类型：
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作者：
Basta, Nicole E.;Stuart, James M.;Greenwood, Brian
目的：脑膜炎球菌携带者的检测是了解脑膜炎奈瑟菌流行病学的关键，但尚未建立金标准。在这里，我们直接比较两种方法收集咽拭子，以确定脑膜炎球菌carrier.Methods：我们进行了横断面调查的学童在多个地点在非洲，比较拭子后咽悬雍垂（U），拭子后咽悬雍垂后面加一个扁桃体（T）。拭子立即培养和分析，使用分子methods.Results：1006配对拭子样本收集的学童在四个国家进行了分析。基于两种拭子的结果，脑膜炎球菌携带率为6.9%（95% CI：5.4-8.6%），但仅基于一种拭子类型观察到的患病率较低。基于T拭子或U拭子单独的患病率相似（分别为5.2%（95% CI：3.8-6.7%）和4.9%（95% CI：3.6-6.4%）（p=0.6））。这两种方法之间的一致性为96.3%和Kappa为0.61（95%CI：0.50-0.73），表明良好agreement.Conclusions：这两种常用的方法收集咽拭子提供一致的估计的患病率的携带，但这两种方法错误分类的载体在一定程度上，导致低估的患病率。
Objective: Detection of meningococcal carriers is key to understanding the epidemiology of Neisseria meningitidis, yet no gold standard has been established. Here, we directly compare two methods for collecting pharyngeal swabs to identify meningococcal carriers.Methods: We conducted cross-sectional surveys of schoolchildren at multiple sites in Africa to compare swabbing the posterior pharynx behind the uvula (U) to swabbing the posterior pharynx behind the uvula plus one tonsil (T). Swabs were cultured immediately and analyzed using molecular methods.Results: One thousand and six paired swab samples collected from schoolchildren in four countries were analyzed. Prevalence of meningococcal carriage was 6.9% (95% CI: 5.4-8.6%) based on the results from both swabs, but the observed prevalence was lower based on one swab type alone. Prevalence based on the T swab or the U swab alone was similar (5.2% (95% CI: 3.8-6.7%) versus 4.9% (95% CI: 3.6-6.4%) respectively (p=0.6)). The concordance between the two methods was 96.3% and the kappa was 0.61 (95% CI: 0.50-0.73), indicating good agreement.Conclusions: These two commonly used methods for collecting pharyngeal swabs provide consistent estimates of the prevalence of carriage, but both methods misclassified carriers to some degree, leading to underestimates of the prevalence.