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Villena R, Safadi MA, Gentile Á, Pujadas M, De la Maza V, George S, Torres JP. Epidemiology of Meningococcal Disease in Four South American Countries and Rationale of Vaccination in Adolescents from the Region: Position Paper of the Latin American Society of Pediatric Infectious Diseases (SLIPE). Vaccines (Basel) 2023; 11:1841. [PMID: 38140244 PMCID: PMC10748232 DOI: 10.3390/vaccines11121841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 12/24/2023] Open
Abstract
Surveillance of meningococcal disease (MD) is crucial after the implementation of vaccination strategies to monitor their impact on disease burden. Adolescent vaccination could provide direct and indirect protection. Argentina, Brazil, and Chile have introduced meningococcal conjugate vaccines (MCV) into their National Immunization Programs (NIP), while Uruguay has not. Here, we analyze the epidemiology of MD and vaccination experience from these four South American countries to identify needs and plans to improve the current vaccination programs. METHODOLOGY Descriptive study of MD incidence rates, serogroup distribution, case fatality rates (CFR), and MCV uptakes during the period 2010-2021 in Argentina, Brazil, Chile, and Uruguay. Data were extracted from national surveillance programs, reference laboratories, NIPs, and Pubmed. RESULTS MD overall incidence from 2010 to 2021 have a decreasing trend in Argentina (0.37 [IQR = 0.20-0.61]), Brazil (0.59 [IQR = 0.54-1.22]), and Chile (0.45 [IQR = 0.40-0.77]), while a significant increase in Uruguay (0.47 [IQR = 0.33-0.69]) was found from 2016 to 2019. During the COVID-19 pandemic, all countries sharply reduced their MD incidence. The highest incidence rates were observed among infants, followed by children 1-4 years of age. No second peak was evident in adolescents. A reduction in serogroup C, W, and Y cases has occurred in Argentina, Brazil, and Chile after introduction of MCV, serogroup B becoming predominant in all four countries. Median CFR was 9.0%, 21%, 19.9%, and 17.9% in Argentina, Brazil, Chile, and Uruguay, respectively. Median uptake of MCV for Argentina and Brazil were 66.6% and 91.0% for priming in infants; 54.7% and 84.5% for booster in toddlers; and 47.5% and 53% for adolescents; while for Chile, 95.6% for toddlers. CONCLUSIONS Experience after the implementation of MCV programs in South America was successful, reducing the burden of MD due to the vaccine serogroups. High vaccine uptake and the inclusion of adolescents will be crucial in the post-pandemic period to maintain the protection of the population. The increase in the proportion of serogroup B cases emphasizes the importance of continuous surveillance to guide future vaccination strategies.
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Affiliation(s)
- Rodolfo Villena
- Department of Pediatrics, Hospital de Niños Exequiel González Cortés, Faculty of Medicine, Universidad de Chile, Santiago 8900085, Chile;
| | - Marco Aurelio Safadi
- Department of Pediatrics, School of Medical Sciences, Santa Casa de Sao Paulo, Sao Paulo 01224-001, Brazil;
| | - Ángela Gentile
- Department of Epidemiology, Hospital de Niños Ricardo Gutierrez, Faculty of Medicine, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires C1121, Argentina;
| | - Mónica Pujadas
- Department of Epidemiology and Pediatrics Infectious Diseases, Hospital Pereira Rossell, Faculty of Medicine, University of the Republic, Montevideo 11400, Uruguay;
| | - Verónica De la Maza
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago 7500539, Chile; (V.D.l.M.); (S.G.)
| | - Sergio George
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago 7500539, Chile; (V.D.l.M.); (S.G.)
| | - Juan Pablo Torres
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago 7500539, Chile; (V.D.l.M.); (S.G.)
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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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Roteli-Martins CM, Neves NA, Magno VA, Kfouri R. Vaccination for meningococcal disease. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA / RBGO GYNECOLOGY AND OBSTETRICS 2022; 44:901-906. [PMID: 36216269 PMCID: PMC9948111 DOI: 10.1055/s-0042-1757755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | - Renato Kfouri
- Centro de Imunização Santa Joana, São Paulo, SP, Brazil
- Centro de Imunização ProMatre Paulista, São Paulo, SP, Brazil
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Kizil MC, Kilic O, Ceyhan M, Iseri Nepesov M, Karbuz A, Kurugol Z, Hacimustafaoglu M, Celebi S, Dinleyici M, Carman KB, Bayhan C, Balliel Y, Sutcu M, Kuyucu N, Kondolot M, Kara SS, Ocal Demir S, Cay U, Gayretli Aydin ZG, Kaya M, Dinleyici EC. Nasopharyngeal Meningococcal Carriage among Children and Adolescents in Turkey in 2018: An Unexpected High Serogroup X Carriage. CHILDREN-BASEL 2021; 8:children8100871. [PMID: 34682136 PMCID: PMC8534370 DOI: 10.3390/children8100871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/18/2021] [Accepted: 09/26/2021] [Indexed: 12/03/2022]
Abstract
Meningococcal carriage studies and transmission modeling can predict IMD epidemiology and used to define invasive meningococcal disease (IMD) control strategies. In this multicenter study, we aimed to evaluate the prevalence of nasopharyngeal Neisseria meningitidis (Nm) carriage, serogroup distribution, and related risk factors in Turkey. Nasopharyngeal samples were collected from a total of 1267 children and adolescents and were tested with rt-PCR. Nm carriage was detected in 96 participants (7.5%, 95% CI 6.1–9.0), with the peak age at 13 years (12.5%). Regarding age groups, Nm carriage rate was 7% in the 0–5 age group, was 6.9%in the 6–10 age group, was 7.9% in the 11–14 age group, and was 9.3% in the 15–18 age group. There was no statistically significant difference between the groups (p > 0.05). The serogroup distribution was as follows: 25% MenX, 9.4% MenA, 9.4% MenB, 2.1% MenC, 3.1% MenW, 2.1% for MenY, and 48.9% for non-groupable. The Nm carriage rate was higher in children with previous upper respiratory tract infections and with a high number of household members, whereas it was lower in children with antibiotic use in the last month (p < 0.05 for all). In this study, MenX is the predominant carriage strain. The geographical distribution of Nm strains varies, but serogroup distribution in the same country might change in a matter of years. Adequate surveillance and/or a proper carriage study is paramount for accurate/dynamic serogroup distribution and the impact of the proposed vaccination.
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Affiliation(s)
- Mahmut Can Kizil
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey; (M.C.K.); (O.K.); (M.I.N.)
| | - Omer Kilic
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey; (M.C.K.); (O.K.); (M.I.N.)
| | - Mehmet Ceyhan
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey;
| | - Merve Iseri Nepesov
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey; (M.C.K.); (O.K.); (M.I.N.)
| | - Adem Karbuz
- Tascioglu City Hospital Division of Pediatric Infectious Diseases, Istanbul 34000, Turkey;
| | - Zafer Kurugol
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35000, Turkey;
| | - Mustafa Hacimustafaoglu
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa 16059, Turkey; (M.H.); (S.C.)
| | - Solmaz Celebi
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa 16059, Turkey; (M.H.); (S.C.)
| | - Meltem Dinleyici
- Division of Social Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey;
| | - Kursat Bora Carman
- Division of Pediatric Neurology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey;
| | - Cihangul Bayhan
- Division of Pediatric Infectious Diseases, Gulhane Training and Research Hospital, Ankara 06300, Turkey;
| | - Yasemin Balliel
- Antalya Muratpaşa Çaybaşı No:1 Family Health Center, Antalya 07000, Turkey;
| | - Murat Sutcu
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul 34010, Turkey;
| | - Necdet Kuyucu
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Mersin University, Mersin 33343, Turkey;
| | - Meda Kondolot
- Division of Social Pediatrics, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey;
| | - Soner Sertan Kara
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Aydin Adnan Menderes University, Aydin 09010, Turkey;
| | - Sevliya Ocal Demir
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34000, Turkey;
| | - Ummuhan Cay
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Cukurova University, Adana 01330, Turkey;
| | - Zeynep Gokce Gayretli Aydin
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey;
| | | | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Ener Cagri Dinleyici, Eskisehir Osmangazi University, Eskisehir 26040, Turkey
- Correspondence:
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Gentile A, Della Latta MP, Bloch M, Martorelli L, Wisner B, Sorhouet Pereira C, Regueira M, Juarez MDV, Umido V, Efron A. Oropharyngeal meningococcal carriage in children and adolescents, a single center study in Buenos Aires, Argentina. PLoS One 2021; 16:e0247991. [PMID: 33780457 PMCID: PMC8006983 DOI: 10.1371/journal.pone.0247991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Neisseria meningitidis (Nm) pharyngeal carriage is a necessary condition for invasive disease. We present the first carriage study in children in Buenos Aires, Argentina, considering 2017 as a transition year. Aims: to assess the rate of Nm carriage, to determine genogroup, clonal complex and outer membrane protein distribution, to determine carriage risk factors by age. Methods Cross-sectional study including children 1–17 yrs, at Ricardo Gutiérrez Children’s Hospital in Buenos Aires 2017. Oro-pharyngeal swabs were taken and cultured within a short time after collection. Genogroup was determined by PCR and clonal complex by MLST. Categorical variables were analyzed. Results A total of 1,751 children were included. Group 1: 943 children 1–9 yrs, 38 Nm were isolated; overall carriage 4.0%. Genogroup distribution: B 26.3%, W 5.3%, Y 2.6%, Z 5.3%, other groups 7.9% and capsule null (cnl) 52.6%. Participating in extracurricular activities was the only independent predictor of Nm carriage. Group 2: 808 children 10–17 yrs, 76 Nm were isolated; overall carriage 9.4%. Genogroup distribution: B 19.7%, C 5.3%, W 7.9%, Y 9.2%, Z 5.3%, other groups 7.9% and cnl 44.7%. Independent predictors of carriage: attending pubs/night clubs and passive smoking (adjusted OR: 0.55, 95%CI = 0.32–0.93; p = 0.025). Conclusions Overall carriage was higher in 10–17 yrs. The isolates presenting the cnl locus were prevalent in both age groups and genogroup B was the second most frequent.
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Affiliation(s)
- Angela Gentile
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
- * E-mail:
| | | | - Mercedes Bloch
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | - Luisina Martorelli
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Barbara Wisner
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | | | - Mabel Regueira
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Maria del Valle Juarez
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | - Veronica Umido
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | - Adriana Efron
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
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Meningococcal disease epidemiology in Brazil (2005-2018) and impact of MenC vaccination. Vaccine 2020; 39:605-616. [PMID: 33358262 DOI: 10.1016/j.vaccine.2020.11.067] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Meningococcal disease (MD) presents a substantial public health problem in Brazil. Meningococcal C conjugate (MenC) vaccination was introduced into the routine infant immunization program in 2010, followed by adolescent vaccination in 2017. We evaluated changes in national and regional MD incidence and mortality between 2005 and 2018, serogroup distribution and vaccine coverage. METHODS Data were obtained from national surveillance systems from 2005 to 2018. Age-stratified incidence and mortality rates were calculated and a descriptive time-series analysis was performed comparing rates in the pre-(2005-2009) and post-vaccination (2011-2018) periods; MD due to specific meningococcal serogroups were analyzed in the pre-(2007-2009) and post-vaccination (2011-2018) periods. RESULTS From 2005 to 2018, 31,108 MD cases were reported with 6496 deaths; 35% of cases and deaths occurred in children < 5 years. Incidence and mortality rates declined steadily since 2012 in all age-strata, with significantly lower incidence and mortality in the post-vaccine introduction period in children aged < 1-year, 1-4 years, 5-9 years and 10-14 years. A significant decline in MenC disease in children < 5 years was observed following MenC vaccine introduction; infants < 1 year, from 3.30/100,000 (2007-2009) to 1.08/100,000 (2011-2018) and from 1.44/100,000 to 0.42/100,000 in 1-4-year-olds for these periods. Reductions in MenB disease was also observed. MenW remains an important cause of MD with 748 cases reported across 2005-2018. While initial infant vaccination coverage was high (>95% nationwide), this has since declined (to 83% in 2018); adolescent uptake was < 20% in 2017/18). Regional variations in outcomes and vaccine coverage were observed. CONCLUSION A substantial decline in incidence and mortality rates due to MD was seen following MenC vaccine introduction in Brazil, especially among children < 5 years chiefly driven by reductions in MenC serogroup. While these benefits are considerable, the prevalence of MD due to other serogroups such as MenW and MenB remains a concern. A video summary linked to this article can be found on Figshare: https://doi.org/10.6084/m9.figshare.13379612.v1.
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Serra L, Presa J, Christensen H, Trotter C. Carriage of Neisseria Meningitidis in Low and Middle Income Countries of the Americas and Asia: A Review of the Literature. Infect Dis Ther 2020; 9:209-240. [PMID: 32242281 PMCID: PMC7237586 DOI: 10.1007/s40121-020-00291-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Meningococcal colonization, or carriage, can progress to invasive meningococcal disease, a serious public health concern, with rapid progression of disease and severe consequences if left untreated. Information on meningococcal carriage and epidemiology in low/middle income American and Asian countries remains sparse. These data are crucial to ensure that appropriate preventive strategies such as vaccination can be implemented in these regions. The goal of this study was to summarize the Neisseria meningitidis carriage literature in low and middle income countries of the Americas and Asia. METHODS Target countries were categorized as low and middle income according to the International Monetary Fund classification of low income/developing economies and middle income/emerging market economies, respectively. A PubMed search identified English-language publications that examined carriage in these countries. Studies reporting the epidemiology of N. meningitidis carriage or assessing risk factors for carriage were included. RESULTS Fourteen studies from the Americas [Brazil (n = 7), Chile (n = 3), and Colombia, Cuba, Mexico, and Paraguay (n = 1 each)] and nine from Asia [China (n = 2), India (n = 3), and Malaysia, Nepal, Philippines, and Thailand (n = 1 each)] were identified; an additional Cuban study from the authors' files was also included. Studies were not identified in many target countries, and substantial diversity was observed among study methodologies, populations, and time periods, thereby limiting comparison between studies. The carriage rate in the Americas ranged from 1.6% to 9.9% and from 1.4% to 14.2% in Asia. Consistent risk factors for carriage were not identified. CONCLUSIONS There is a lack of comprehensive and contemporary information on meningococcal carriage in low and medium income countries of the Americas and Asia. Future carriage studies should incorporate larger representative populations, a wider age range, and additional countries to improve our understanding of meningococcal epidemiology and disease control.
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Affiliation(s)
- Lidia Serra
- Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Collegeville, PA, USA.
| | - Jessica Presa
- Pfizer Vaccines, Medical and Scientific Affairs, Collegeville, PA, USA
| | - Hannah Christensen
- Bristol Medical School, Population Health Sciences, University of Bristol, Clifton, UK
| | - Caroline Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Ferreira VM, Ferreira ÍE, Chang HY, Nunes AMPB, Topaz N, Pimentel ER, Moura ARSS, Ribeiro GS, Feitosa CA, Reis MG, Wang X, Campos LC. Meningococcal carriage in young adults six years after meningococcal C conjugate (MCC) vaccine catch-up campaign in Salvador, Brazil. Vaccine 2020; 38:2995-3002. [PMID: 32115294 DOI: 10.1016/j.vaccine.2020.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Abstract
Meningococcal carriage studies are important to improve the knowledge of disease epidemiology as well as to support appropriate vaccination strategies. We conducted a cross-sectional study to determine the prevalence and genotypic characteristics of meningococci collected from young adults in Salvador, Brazil six years after a meningococcal C conjugate vaccine catch-up campaign. From August through November 2016, oropharyngeal swabs were collected from 407 students aged 1824 years attending a private college in Salvador, Brazil. Neisseria meningitidis was identified by standard microbiology methods and real time PCR. Genetic characteristics of meningococci were assessed by rt-PCR and/or whole genome sequencing. We also investigated potential factors associated with carriage. N. meningitidis was detectable in 50 students, 39 by both culture and rt-PCR, 7 by culture alone and 4 by rt-PCR alone, resulting in an overall meningococcal carriage prevalence of 12.3% (50/407). Carriage was independently associated with male sex (adjusted PR: 1.97; 95% CI: 1.12-3.46; p = 0.018) and attending bars or parties at least once per month (aPR: 3.31; 95% CI: 1.49-7.38; p = 0.003). Molecular tests identified 92% (46/50) N. meningitidis as non-groupable, of which 63% (29/46) had the capsule null genotype; 14 NG isolates contained disrupted capsule backbones and belonged to the following genogroups: 7 B, 3 Z, 3 E and 1 W. One isolate belonged to genogroup C tested only by PCR; 3 isolates contained a complete B capsule backbones, 2 of which were determined to be NG by slide agglutination serogrouping. While most meningococcal carriage isolates were non-groupable, there was a high degree of genetic diversity present in the collection, as evidenced by 25 unique STs being detected. The carriage prevalence of meningococcal serogroup C was low among young adults. Continuous vaccination is important to maintain reduced meningococcal carriage and transmission, inducing herd protection.
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Affiliation(s)
- Viviane Matos Ferreira
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | | | - How-Yi Chang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Nadav Topaz
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Guilherme Sousa Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | - Mitermayer Galvão Reis
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States
| | - Xin Wang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Epidemiological burden of meningococcal disease in Latin America: A systematic literature review. Int J Infect Dis 2019; 85:37-48. [DOI: 10.1016/j.ijid.2019.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022] Open
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Santos-Neto JF, Ferreira VM, Feitosa CA, Martinez-Silveira MS, Campos LC. Carriage prevalence of Neisseria meningitidis in the Americas in the 21st century: a systematic review. Braz J Infect Dis 2019; 23:254-267. [PMID: 31344352 PMCID: PMC9427833 DOI: 10.1016/j.bjid.2019.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/17/2019] [Accepted: 06/26/2019] [Indexed: 01/13/2023] Open
Abstract
Neisseria meningitidis is a bacterium that colonizes the human nasopharynx and is transmitted by respiratory droplets from asymptomatic or symptomatic carriers. Occasionally, the pathogen invades the mucosa and enters the bloodstream, causing invasive meningococcal disease, a life-threatening infection. While meningococcal colonization is the first step in the development of invasive disease, the risk factors that predict progression from asymptomatic to symptomatic status are not well-known. The present report aimed to describe the prevalence of N. meningitidis carriers throughout the Americas, emphasizing the risk factors associated with carrier status, as well as the most prevalent serogroups in each studied population. We conducted a systematic review by searching for original studies in the MEDLINE/PubMed, Embase, LILACS and SciELO databases, published between 2001 and 2018. Exclusion criteria were articles published in a review format, case studies, case control studies, investigations involving animal models, and techniques or publications that did not address the prevalence of asymptomatic carriers in an American country. A total of 784 articles were identified, of which 23 were selected. The results indicate that the highest prevalence rates are concentrated in Cuba (31.9%), the United States (24%), and Brazil (21.5%), with increased prevalence found among adolescents and young adults, specifically university students and males. The present systematic review was designed to support epidemiological surveillance and prevention measures to aid in the formulation of strategies designed to control the transmission of meningococci in a variety of populations and countries throughout the Americas.
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Affiliation(s)
- José Francisco Santos-Neto
- Instituto Gonçalo Moniz - FIOCRUZ, Salvador, BA, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| | - Viviane Matos Ferreira
- Instituto Gonçalo Moniz - FIOCRUZ, Salvador, BA, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
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Sadeghi M, Ahmadrajabi R, Dehesh T, Saffari F. Prevalence of meningococcal carriage among male university students living in dormitories in Kerman, southeast of Iran. Pathog Glob Health 2018; 112:329-333. [PMID: 30156971 DOI: 10.1080/20477724.2018.1514138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Neisseria meningitidis is an important causative agent of bacterial meningitis. The nasopharynx is the only known reservoir of this organism. Although the relationship between carriage and invasive disease is not completely understood, asymptomatic meningococcal carriers are considered as the most important sources for causing strains of disease. Living in closed and overcrowded places such as university dormitories can increase the carriage rate and meningococcal disease. This cross-sectional study was conducted to determine the prevalence of N. meningitidis carriers among male students living in three dormitories affiliated with Kerman University of Medical Sciences (Kerman, Iran). Nasopharyngeal swab was taken from all participants recruited in the study. Conventional microbiological tests were performed for isolation and detection of the organism. The amplification of crgA gene was used to confirm the identity of isolates. Molecular serogrouping was used to detect the six most frequent serotypes. The overall carriage rate was 6.8% (23/335). The capsular type of these isolates was in determinate (56.5%) or of serogroup C (43.5%). Multivariate logistic regression analysis revealed that cigarette smoking was significantly associated with meningococcal carriage (OR = 5.02; p = 0.01). Additionally, using univariate regression analysis, a significant association was found between water pipe smoking and carriage (p = 0.018). The rate of meningococcal carriage among male students in the studied population was lower as compared to other high-risk group (freshmen conscripts) in Iran. University students should be aware of the consequences of cigarette and water pipe smoking as risk factors in meningococcal carriage.
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Affiliation(s)
- Mohammad Sadeghi
- a Department of Microbiology and Virology, School of Medicine , Kerman University of Medical Sciences , Kerman , Iran
| | - Roya Ahmadrajabi
- a Department of Microbiology and Virology, School of Medicine , Kerman University of Medical Sciences , Kerman , Iran
| | - Tania Dehesh
- b Department of Epidemiology and Biostatistics, School of Public Health , Kerman University of Medical Sciences , Kerman , Iran
| | - Fereshteh Saffari
- a Department of Microbiology and Virology, School of Medicine , Kerman University of Medical Sciences , Kerman , Iran
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