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Mbaeyi S, Sampo E, Dinanibè K, Yaméogo I, Congo-Ouédraogo M, Tamboura M, Sawadogo G, Ouattara K, Sanou M, Kiemtoré T, Dioma G, Sanon B, Somlaré H, Kyetega A, Ba AK, Aké F, Tarbangdo F, Aboua FA, Donnou Y, Kamaté I, Patel JC, Schmink S, Spiller MW, Topaz N, Novak R, Wang X, Bicaba B, Sangaré L, Ouédraogo-Traoré R, Kristiansen PA. Meningococcal carriage 7 years after introduction of a serogroup A meningococcal conjugate vaccine in Burkina Faso: results from four cross-sectional carriage surveys. Lancet Infect Dis 2020; 20:1418-1425. [PMID: 32653071 PMCID: PMC7689286 DOI: 10.1016/s1473-3099(20)30239-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/05/2020] [Accepted: 03/12/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND In the first 2 years after a nationwide mass vaccination campaign of 1-29-year-olds with a meningococcal serogroup A conjugate vaccine (MenAfriVac) in Burkina Faso, carriage and disease due to serogroup A Neisseria meningitidis were nearly eliminated. We aimed to assess the long-term effect of MenAfriVac vaccination on meningococcal carriage and herd immunity. METHODS We did four cross-sectional studies of meningococcal carriage in people aged 9 months to 36 years in two districts of Burkina Faso between May 2, 2016, and Nov 6, 2017. Demographic information and oropharyngeal swabs were collected. Meningococcal isolates were characterised using whole-genome sequencing. FINDINGS Of 14 295 eligible people, 13 758 consented and had specimens collected and laboratory results available, 1035 of whom were meningococcal carriers. Accounting for the complex survey design, prevalence of meningococcal carriage was 7·60% (95% CI 5·67-9·52), including 6·98% (4·86-9·11) non-groupable, 0·48% (0·01-0·95) serogroup W, 0·10% (0·01-0·18) serogroup C, 0·03% (0·00-0·80) serogroup E, and 0% serogroup A. Prevalence ranged from 5·44% (95% CI 4·18-6·69) to 9·14% (6·01-12·27) by district, from 4·67% (2·71-6·64) to 11·17% (6·75-15·59) by round, and from 3·39% (0·00-8·30) to 10·43% (8·08-12·79) by age group. By clonal complex, 822 (88%) of 934 non-groupable isolates were CC192, all 83 (100%) serogroup W isolates were CC11, and nine (69%) of 13 serogroup C isolates were CC10217. INTERPRETATION Our results show the continued effect of MenAfriVac on serogroup A meningococcal carriage, for at least 7 years, among vaccinated and unvaccinated cohorts. Carriage prevalence of epidemic-prone serogroup C CC10217 and serogroup W CC11 was low. Continued monitoring of N meningitidis carriage will be crucial to further assess the effect of MenAfriVac and inform the vaccination strategy for future multivalent meningococcal vaccines. FUNDING Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.
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Affiliation(s)
- Sarah Mbaeyi
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Kambiré Dinanibè
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Issaka Yaméogo
- Direction de la Protection de la Santé de la Population, Burkina Faso Ministry of Health, Ouagadougou, Burkina Faso
| | | | - Mamadou Tamboura
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Guetawendé Sawadogo
- Direction de la Protection de la Santé de la Population, Burkina Faso Ministry of Health, Ouagadougou, Burkina Faso
| | - Kalifa Ouattara
- Centre Hospitalier Universitaire de Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Mahamadou Sanou
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Tanga Kiemtoré
- Direction de la Protection de la Santé de la Population, Burkina Faso Ministry of Health, Ouagadougou, Burkina Faso
| | - Gerard Dioma
- Centre Hospitalier Universitaire de Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Barnabé Sanon
- Centre Hospitalier Régional de Kaya, Kaya, Burkina Faso
| | - Hermann Somlaré
- Centre Hospitalier Universitaire de Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Augustin Kyetega
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Absatou Ky Ba
- Centre Hospitalier Universitaire du Bogodogo, Ouagadougou, Burkina Faso
| | - Flavien Aké
- Davycas International, Gounghin Petit-Paris, Ouagadougou, Burkina Faso
| | - Félix Tarbangdo
- Davycas International, Gounghin Petit-Paris, Ouagadougou, Burkina Faso
| | | | - Yvette Donnou
- Davycas International, Gounghin Petit-Paris, Ouagadougou, Burkina Faso
| | - Idrissa Kamaté
- World Health Organization, Intercountry Support Team, Ouagadougou, Burkina Faso
| | - Jaymin C Patel
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susanna Schmink
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michael W Spiller
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nadav Topaz
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ryan Novak
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xin Wang
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brice Bicaba
- Direction de la Protection de la Santé de la Population, Burkina Faso Ministry of Health, Ouagadougou, Burkina Faso
| | - Lassana Sangaré
- Centre Hospitalier Universitaire de Yalgado Ouédraogo, Ouagadougou, Burkina Faso
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