Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Feb;24(2):143-154.
doi: 10.1111/tmi.13185. Epub 2018 Dec 6.

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Brian M Greenwood  1 , Abraham Aseffa  2 , Dominique A Caugant  3 , Kanny Diallo  4 , Paul A Kristiansen  3 , Martin C J Maiden  5 , James M Stuart  1 , Caroline L Trotter  6
Affiliations
Review

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Brian M Greenwood et al. Trop Med Int Health. 2019 Feb.

Abstract
in English, French

Objective: To review the findings of studies of pharyngeal carriage of Neisseria meningitidis and related species conducted in the African meningitis belt since a previous review published in 2007.

Methods: PubMed and Web of Science were searched in July 2018 using the terms 'meningococcal OR Neisseria meningitidis OR lactamica AND carriage AND Africa', with the search limited to papers published on or after 1st January 2007. We conducted a narrative review of these publications.

Results: One hundred and thirteen papers were identified using the search terms described above, 20 of which reported new data from surveys conducted in an African meningitis belt country. These papers described 40 surveys conducted before the introduction of the group A meningococcal conjugate vaccine (MenAfriVacR ) during which 66 707 pharyngeal swabs were obtained. Carriage prevalence of N. meningitidis varied substantially by time and place, ranging from <1% to 24%. The mean pharyngeal carriage prevalence of N. meningitidis across all surveys was 4.5% [95% CI: 3.4%, 6.8%] and that of capsulated N. meningitidis was 2.8% [95% CI: 1.9%; 5.2%]. A study of households provided strong evidence for meningococcal transmission within and outside households. The introduction of MenAfriVac® led to marked reductions in carriage of the serogroup A meningococcus in Burkina Faso and Chad.

Conclusions: Recent studies employing standardised methods confirm the findings of older studies that carriage of N. meningitidis in the African meningitis belt is highly variable over time and place, but generally occurs with a lower prevalence and shorter duration than reported from industrialised countries.

Objectif: Passer en revue les résultats d’études sur le portage pharyngé de Neisseria meningitidis et des espèces apparentées, menées dans la ceinture africaine de la méningite depuis un précédent rapport publié en 2007.

Méthodes: Des recherches sur PubMed et Web of Science ont été effectuées en juillet 2018 en utilisant les termes «méningocoque OU Neisseria meningitidis OU lactamica ET portage ET Afrique». La recherche a été limitée aux articles publiés à partir du 1(er janvier 2007. Nous avons effectué une analyse narrative de ces publications.

Résultats: 113 articles ont été identifiés en utilisant les termes de recherche décrits ci‐dessus, dont 20 rapportaient de nouvelles données provenant d'enquêtes menées dans un pays africain de la ceinture de la méningite. Ces articles décrivaient 40 enquêtes menées avant l'introduction du vaccin conjugué contre le méningocoque du groupe A (MenAfriVac®), au cours de laquelle 66.707 prélèvements pharyngés sur écouvillons ont été obtenus. La prévalence de portage de N. meningitidis variait considérablement selon le temps et le lieu, allant de <1% à 24%. La prévalence moyenne de portage pharyngé de N. meningitidis dans toutes les enquêtes était de 4,5% [IC95%: 3,4% à 6,8%] et de 2,8% pour celle de N. meningitidis encapsulée [IC95%: 1,9% à 5,2%]. Une étude sur les ménages a fourni des preuves solides de la transmission du méningocoque à l'intérieur et à l'extérieur des ménages. L'introduction de MenAfriVac® a entraîné une réduction marquée du portage du méningocoque du sérogroupe A au Burkina Faso et au Tchad.

Conclusions: Des études récentes utilisant des méthodes standardisées confirment les résultats d’études antérieures selon lesquels le portage de N. meningitidis dans la ceinture africaine de la méningite est très variable dans le temps et le lieu, mais survient généralement avec une prévalence inférieure et une durée plus courte que celle rapportée dans les pays industrialisés.

Keywords: Neisseria meningitidis; African meningitis belt; ceinture africaine de la méningite; meningococcal carriage; portage du méningocoque.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Search methods employed to identify papers published since 2007 relevant to carriage of meningococci in the African meningitis belt.
Figure 2
Figure 2
The impact of group A meningococcal conjugate vaccine MenAfriVacR on pharyngeal carriage of the group A meningococcus in (a) Burkina Faso and (b) Chad 4. Figure 2a is modified from reference 5 with permission.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Phair JJ, Schoenbach EB, Root CM. Meningococcal carrier studies. Amer J Public Health Nations Health 1944: 34: 148–154. - PMC - PubMed
    1. Maiden MC, Ibarz‐Pavon AB, Urwin R et al Impact of meningococcal serogroup C: conjugate vaccines on carriage and herd immunity. J Infect Dis 2008: 197: 737–743. - PMC - PubMed
    1. Trotter CL, Maiden MC. Meningococcal vaccines and herd immunity: lessons learned from serogroup C conjugate vaccination programs. Expert Rev Vaccines 2009: 8: 851–861. - PMC - PubMed
    1. Daugla D, Gami J, Gamougam K et al Effect of a serogroup A meningococcal conjugate vaccine (PsA‐TT) on serogroup A meningococcal meningitis and carriage in Chad: a community trial. Lancet 2014: 383: 40–47. - PMC - PubMed
    1. Kristiansen PA, Ba A, Ouédraogo AS et al Persistent low carriage of serogroup A Neisseria meningitidis two years after mass vaccination with the meningococcal conjugate vaccine, MenAfriVac. BMC Infect Dis 2014: 14: 663. - PMC - PubMed

MeSH terms