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Neisseria meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners at Jimma zonal correction facility in Jimma Town, Southwestern Ethiopia: a cross-sectional study. Trop Med Health 2022; 50:67. [PMID: 36114580 PMCID: PMC9479249 DOI: 10.1186/s41182-022-00462-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Neisseria meningitidis causes severe life-threatening meningococcal disease with a case fatality rate of 10–15% even with proper treatment. In Ethiopia, particularly in our study area, inadequate information is found on meningococcal disease. So, this study aimed to assess N. meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners in Jimma Town, Southwestern Ethiopia.
Methods
A cross-sectional study was conducted in Jimma town, Southwest Ethiopia, from May to October 2019. A stratified sampling technique was used and proportional allocation was done. A total of 550 oropharyngeal swabs were collected, processed, isolated, and identified N. meningitidis using standard microbiological techniques. Antibiotics susceptibility test was done for isolates using the disk diffusion method. Data on demographic and associated factors for carriage were collected using a structured questionnaire. Data were summarized using frequency, percentage, graph, and table. A logistic regression model was used to see the association between the dependent and independent variables. Variables with a p-value < 0.25 during bivariate analysis were included in multivariate analysis to identify factors significantly associated with the meningococcal carriage and, a p-value < 0.05 was considered statistically significant.
Result
Out of the 550 study participants, 76(13.8%) with (CI: 7.20–18.20) were found carriers of N meningitidis. The predominant isolates were non-serogroupable 26(34.2%) and serogroup W/Y 22(28.9%), respectively. N. meningitidis isolates showed highest sensitivity to chloramphenicol 74(97.4%). Meningococcal carriage rate was significantly associated with being age group of 16–20 years; having respiratory symptoms within 3 months and active cigarette smoking within 3 months.
Conclusions
The majority of participants harbor most of the serogroups responsible for invasive cases of meningococcal disease. Respiratory symptoms, active cigarette smoking, and age group of 16–20 years increased the risk of N. meningitidis pharyngeal carriage rate. This study suggests providing better health education to control respiratory symptoms, smoking, and providing antibiotic prophylaxis for prisoners.
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Carr JP, MacLennan JM, Plested E, Bratcher HB, Harrison OB, Aley PK, Bray JE, Camara S, Rodrigues CMC, Davis K, Bartolf A, Baxter D, Cameron JC, Cunningham R, Faust SN, Fidler K, Gowda R, Heath PT, Hughes S, Khajuria S, Orr D, Raman M, Smith A, Turner DP, Whittaker E, Williams CJ, Zipitis CS, Pollard AJ, Oliver J, Morales-Aza B, Lekshmi A, Clark SA, Borrow R, Christensen H, Trotter C, Finn A, Maiden MCJ, Snape MD. Impact of meningococcal ACWY conjugate vaccines on pharyngeal carriage in adolescents: evidence for herd protection from the UK MenACWY programme. Clin Microbiol Infect 2022; 28:1649.e1-1649.e8. [PMID: 35840033 DOI: 10.1016/j.cmi.2022.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Serogroup W and Y invasive meningococcal disease (IMD) increased globally from 2000 onwards. Responding to a rapid increase in serogroup W clonal complex 11 (W:cc11) IMD, the UK replaced an adolescent booster dose of meningococcal C conjugate vaccine with quadrivalent MenACWY conjugate vaccine in 2015. By 2018, vaccine coverage in the eligible school cohorts aged 14-19 years-old was 84%. We assessed the impact of the MenACWY vaccination programme on meningococcal carriage. METHODS An observational study of culture-defined oropharyngeal meningococcal carriage prevalence before and after the start of the MenACWY vaccination programme in UK school students, aged 15-19 years, using two cross-sectional studies: 2014-15 "UKMenCar4" and 2018 "Be on the TEAM" (ISRCTN75858406). RESULTS A total of 10625 participants pre-implementation and 13434 post-implementation were included. Carriage of genogroups C, W, and Y (combined) decreased from 2·03% to 0·71% (OR 0·34 [95% CI 0·27-0·44] p<0·001). Carriage of genogroup B meningococci did not change (1·26% vs 1·23% [95% CI 0.77-1.22] p=0·80) and genogroup C remained rare (n = 7/10625 vs 17/13488, p=0·135). The proportion of serogroup positive isolates, i.e., those expressing capsule, decreased for genogroup W by 53.8% (95% CI -5.0%-79.8%, p=0·016) and for genogroup Y by 30·1% (95% CI 8·9%-46·3%, p=0·0025). CONCLUSIONS The UK MenACWY vaccination programme reduced carriage acquisition of genogroup and serogroup Y and W meningococci and sustained low levels of genogroup C carriage. These data support the use of quadrivalent MenACWY conjugate vaccine for indirect (herd) protection.
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Affiliation(s)
- Jeremy P Carr
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK; Monash University, Melbourne, Australia; Monash Children's Hospital, Melbourne, Australia
| | | | - Emma Plested
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK
| | | | | | - Parvinder K Aley
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK
| | | | - Susana Camara
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK
| | - Charlene M C Rodrigues
- Department of Zoology, University of Oxford, UK; Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Kimberly Davis
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK
| | - Angela Bartolf
- St George's Vaccine Institute, Institute of Infection & Immunity; St George's University of London, UK
| | | | | | | | - Saul N Faust
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust; and Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Katy Fidler
- Brighton and Sussex Medical School, UK; Royal Alexandra Children's Hospital, University Hospital Sussex NHS Foundation Trust, Brighton, UK
| | | | - Paul T Heath
- St George's Vaccine Institute, Institute of Infection & Immunity; St George's University of London, UK
| | - Stephen Hughes
- Royal Manchester Children's Hospital; Manchester University NHS Foundation Trust, UK
| | | | - David Orr
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - Mala Raman
- University Hospitals Plymouth NHS Foundation Trust, UK
| | - Andrew Smith
- Glasgow Dental Hospital & School, College of Medical, Veterinary & Life Sciences, University of Glasgow, UK
| | - David Pj Turner
- School of Life Sciences, University of Nottingham & Nottingham University Hospitals NHS Trust, UK
| | - Elizabeth Whittaker
- Imperial College London, UK; Imperial College Healthcare NHS Trust, London, UK
| | | | - Christos S Zipitis
- Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK
| | - Jennifer Oliver
- Bristol Children's Vaccine Centre, University of Bristol, UK
| | | | - Aiswarya Lekshmi
- UK Health Security Agency Meningococcal Reference Unit, Manchester Royal Infirmary Manchester, UK
| | - Stephen A Clark
- UK Health Security Agency Meningococcal Reference Unit, Manchester Royal Infirmary Manchester, UK
| | - Ray Borrow
- UK Health Security Agency Meningococcal Reference Unit, Manchester Royal Infirmary Manchester, UK
| | - Hannah Christensen
- School of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | | | - Adam Finn
- School of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Martin C J Maiden
- Department of Zoology, University of Oxford, 11a Mansfield Road, Oxford, OX1 3SZ, United Kingdom.
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK
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McMillan M, Chandrakumar A, Wang HLR, Clarke M, Sullivan TR, Andrews RM, Ramsay M, Marshall HS. Effectiveness of Meningococcal Vaccines at Reducing Invasive Meningococcal Disease and Pharyngeal Neisseria meningitidis Carriage: A Systematic Review and Meta-analysis. Clin Infect Dis 2021; 73:e609-e619. [PMID: 33212510 DOI: 10.1093/cid/ciaa1733] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, leads to significant morbidity and mortality worldwide. This review aimed to establish the effectiveness of meningococcal vaccines at preventing IMD and N. meningitidis pharyngeal carriage. METHODS A search within PubMed, Embase, Scopus, and unpublished studies up to 1 February 2020 was conducted. RESULTS After removal of duplicates, 8565 studies were screened and 27 studies included. Protection was provided by meningococcal C vaccines for group C IMD (odds ratio [OR], 0.13 [95% confidence interval {CI}, .07-.23]), outer membrane vesicle (OMV) vaccines against group B IMD (OR, 0.35 [95% CI, .25-.48]), and meningococcal A, C, W, Y (MenACWY) vaccines against group ACWY IMD (OR, 0.31 [95% CI, .20-.49]). A single time series analysis found a reduction following an infant 4CMenB program (incidence rate ratio, 0.25 [95% CI, .19-.36]). Multivalent MenACWY vaccines did not reduce carriage (relative risk [RR], 0.88 [95% CI, .66-1.18]), unlike monovalent C vaccines (RR, 0.50 [95% CI, .26-.97]). 4CMenB vaccine had no effect on group B carriage (RR, 1.12 [95% CI, .90-1.40]). There was also no reduction in group B carriage following MenB-FHbp vaccination (RR, 0.98 [95% CI, .53-1.79]). CONCLUSIONS Meningococcal conjugate C, ACWY, and OMV vaccines are effective at reducing IMD. A small number of studies demonstrate that monovalent C conjugate vaccines reduce pharyngeal N. meningitidis carriage. There is no evidence of carriage reduction for multivalent MenACWY, OMV, or recombinant MenB vaccines, which has implications for immunization strategies. CLINICAL TRIALS REGISTRATION CRD42018082085 (PROSPERO).
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Affiliation(s)
- Mark McMillan
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.,Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Abira Chandrakumar
- Central Adelaide Local Health Network, South Australia Health, Adelaide, South Australia, Australia
| | - Hua Lin Rachael Wang
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Michelle Clarke
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.,Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Thomas R Sullivan
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia,Australia.,School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mary Ramsay
- Immunisation Department, Public Health England, London, United Kingdom
| | - Helen S Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.,Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
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Korzeniewski K, Konior M. Evaluation of Neisseria meningitidis Carriage with the Analysis of Serogroups, Genogroups and Clonal Complexes among Polish Soldiers. Pol J Microbiol 2019; 67:493-500. [PMID: 30550236 PMCID: PMC7256823 DOI: 10.21307/pjm-2018-058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 12/23/2022] Open
Abstract
Neisseria meningitidis is an etiological factor of invasive meningococcal disease (IMD). This Gram-negative diplococcus is transmitted from person to person via droplets or through a direct physical contact with secretions of infected patients or asymptomatic carriers. The latter account for 5–10% of the general population. The aim of the study was to estimate the actual N. meningitidis carriage rate in the military environment with identification of serogroups, genogroups, sequence types and clonal complexes of the isolates detected among Polish soldiers. The study was conducted during winter seasons of 2015 and 2016 and involved 883 professional soldiers from the Armoured Brigade in Świętoszów, Poland. The material for testing were nasopharyngeal swabs obtained from study participants. The samples were tested using standard microbiological methods (culture, incubation, microscopy, biochemical and automated identification). N. meningitidis isolates were subjected to slide agglutination test (identification of serogroups), the bacterial DNA was extracted and allowed to determine genogroups, clonal complexes and sequence types. 76 soldiers were found to be carriers of N. meningitidis, they accounted for 8.6% of the study group. The meningococcal isolates mostly belonged to serogroup B. Sequence types ST-11439, ST-136, ST-1136 and the clonal complex 41/44CC were found to be predominant. Clonal complexes responsible for IMD were detected in 15.8% of carriers and 1.4% of the whole study participants. Carriage rates of N. meningitidis among Polish soldiers were found to be similar to those reported in the general population.
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Affiliation(s)
- Krzysztof Korzeniewski
- Military Institute of Medicine, Department of Epidemiology and Tropical Medicine , Warsaw , Poland
| | - Monika Konior
- Military Institute of Medicine, Department of Epidemiology and Tropical Medicine , Warsaw , Poland
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Observational study of nasopharyngeal carriage of Neisseria meningitidis in applicants to a military academy in the Russian Federation. Int J Infect Dis 2019; 81:12-16. [PMID: 30634039 DOI: 10.1016/j.ijid.2018.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/12/2018] [Accepted: 12/16/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the carriage and the serogroup distribution of Neisseria meningitidis in military academy applicants in the Russian Federation. DESIGN This was a prospective, observational study of adults aged >18years from a military academy; applicants who had samples taken on arrival (Day 1), and applicants who had samples taken after passing exams (Day 30) and 60days after arrival. N. meningitidis serogrouping was determined by slide agglutination tests of isolates and real-time PCR. RESULTS Samples were provided by 671 applicants on Day 1 and 261 applicants on Day 30, with 232 of these also providing samples on Day 60. N. meningitidis was detected in 16.2% of samples from Day 1, 7.7% of samples from Day 30 and 15.9% of samples from Day 60. Serogroup composition was most diverse at Day 1, with serogroups B and W dominant (40% [17/43 isolates] and 9% [4/43], respectively; 30% [13/43] ungroupable); by Day 60, there was a low diversity, with 58% (14/24 isolates) serogroup W. CONCLUSIONS While carriage of N. meningitidis in this study appeared stable, there was an increase in carriers of serogroup W in this population. Given recent increases in outbreaks attributed to serogroup W, further monitoring may be considered.
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