Background. Study of meningococcal carriage is essential to understanding the epidemiology of Neisseria meningitidis infection.Methods. Twenty cross-sectional carriage surveys were conducted in 7 countries in the African meningitis belt; 5 surveys were conducted after introduction of a new serogroup A meningococcal conjugate vaccine (MenAfriVac). Pharyngeal swab specimens were collected, and Neisseria species were identified by microbiological and molecular techniques.Results. A total of 1687 of 48 490 participants (3.4%; 95% confidence interval [CI], 3.2%–3.6%) carried meningococci. Carriage was more frequent in individuals aged 5–14 years, relative to those aged 15–29 years (adjusted odds ratio [OR], 1.41; 95% CI, 1.25–1.60); in males, relative to females (adjusted OR, 1.17; 95% CI, 1.10–1.24); in individuals in rural areas, relative to those in urban areas (adjusted OR, 1.44; 95% CI, 1.28–1.63); and in the dry season, relative to the rainy season (adjusted OR, 1.54; 95% CI, 1.37–1.75). Forty-eight percent of isolates had genes encoding disease-associated polysaccharide capsules; genogroup W predominated, and genogroup A was rare. Strain diversity was lower in countries in the center of the meningitis belt than in Senegal or Ethiopia. The prevalence of genogroup A fell from 0.7% to 0.02% in Chad following mass vaccination with MenAfriVac.Conclusions. The prevalence of meningococcal carriage in the African meningitis belt is lower than in industrialized countries and is very diverse and dynamic, even in the absence of vaccination.

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IntroductionSub-optimal adherence constitutes a significant impediment to the management of severe mental illnesses (SMIs) as it negatively impacts on the course of the illness and the treatment outcome. In this study, the levels of adherence, prevalence and the predictors of sub-optimal adherence were assessed in a sub-Saharan African setting.MethodsThree hundred and seventy (370) respondents with diagnoses of schizophrenia, bipolar disorder or severe depression were randomly enrolled and interviewed at the out-patient department of the Federal Neuropsychiatric Hospital, Maiduguri in northeastern Nigeria. An anonymous sociodemographic questionnaire and a clinical proforma designed by the authors, Oslo social support scale and the 8-item Morisky Medication Adherence Scale (MMAS-8) were used for data collection.ResultsThe prevalence of sub-optimal adherence was 55.7%. The independent predictors of sub-optimal adherence were; seeking for traditional/ spiritual treatment (Odds Ratio (O.R.) = 6.523, 95% C.I. = 3.773 - 11.279, P = < 0.001), male gender (O.R. = 3.307, 95% C.I. = 1.907 - 5.737, P = < 0.001), low levels of insight (O.R. = 1.753, 95 C.I. = 1.220 - 2.519, P = 0.002), and low social support levels (O.R. = 1.528, 95% C.I. = 1.097 - 2.129, P = 0.012).ConclusionBased on the outcome of the study, we recommend the development of psycho-educational programmes on adherence and the active involvement of the relations and significant others in the management of patients with SMIs in sub-Saharan Africa.

Bill & Melinda Gates Foundation, Wellcome Trust.

Background:Methods: Results: Conclusion:Tobacco is the leading preventable cause of death in the United States; responsible for more than 400,000 deaths annually. There have been few reports in the literature about the association between these diseases and cigarette smoking from African countries, which may indicate that these diseases are not common inAfricans. There is a dearth of knowledge about the smoking habit among adolescents and factors influencing it in Africa. This is a survey of the factors influencing the onset of cigarette smoking among adolescents in Konduga local government area.Across-sectional study involving 400 randomly selected subjects from the four districts of the local government who responded to a modified version of the standard WHO questionnaire (WHO/ SMO, 1984) for surveying smoking habit.The study showed that friends/peers (57%) as the major factor for initiating the smoking habit in adolescents. Others were pleasure (24%), stress (13%), family members (4%) and cigarette adverts (1%). The study also revealed that the adolescents continued to smoke even though they were aware of the health consequences of smoking. The majority of the respondents (70%) advocated outright ban on tobacco sales by the government as the most effective way to check this world's major preventable health hazard.The study showed that friends/peer groups were the dominant factor influencing the onset of cigarette smoking among adolescents. This underscores the need for targeting the group in behaviour change communication.