Carriage Rate of Neisseria meningitidis, Antibiotic Susceptibility Pattern and Associated Risk Factors among Primary School Children in Gondar town, Northwest Ethiopia

Abstract

Background: Globally, in 2012, about 1.2 million estimated cases were reported with ~135,000 deaths annually. In Ethiopia, specifically in our study area, limited information is found on the oropharyngeal carriage, antimicrobial resistance pattern, and associated risk factors for N. meningitidis among school children. So, the aim of this study was to assess oropharyngeal carriage rate of N. meningitidis, antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia.Methods: A cross sectional study was conducted from January to April, 2019 in Gondar town. Multi stage simple random sampling technique was used. A total of 524 oropharyngeal swabs were collected using sterile plastic cotton swabs. Modified Thayer Martin media was used for primary isolation. Antimicrobial susceptibility pattern was done based on Kirby-Bauer method on Muller-Hinton agar supplemented with 5% sheep blood. Multidrug resistance was defined as resistance of an isolate to two or more antimicrobial classes tested. Logistic regression model was used to see the association between dependent variables (Carriage rate of Neisseria meningitidis, Serogroups of Neisseria meningitidis and Antimicrobial susceptibility patterns) and independent variables (Socio-demographic data and risk factors). Variables with a P- value ≤ 0.2 during bivariable analysis was taken to multivariable analysis to check significant association of meningococcal carriage with risk factors. Finally, a P-value < 0.05 was considered as statistically significant. Data was summarized using numbers, percentages and tables.Results: A total of 53(10.1%) (CI: 7.6-12.8) N. meningitidis isolates were identified. Serogroup A 13 (24.5%) was the most prevalent followed by Y/W135 11(20.7%) whereas serogroup B 4(7.6%) was the least identified serotype. Meningococcal isolates were resistant to ciprofloxacin (45.3%) and trimethoprim-sulfamethoxazole (73.6%). Overall, most of meningococcal isolates showed about 32(60.4%) multidrug resistance. Meningococcal carriage rate was significantly associated with family size, tonsillectomy, passive smoking, number of students per class, sharing utensils, history of visiting healthcare institutions, and indoor kitchen. Conclusion: This study highlights the need for reinforcement of case-based, laboratory confirmed surveillance of N. meningitidis carriage in Ethiopian elementary school students to enable mapping of distribution of serotypes of the causative organisms across the country and determine the current potential necessity of vaccination.

Prevalence and persistence of Neisseria meningitidis carriage in Swedish university students

“…However, alcohol drinking and party attendance often occur simultaneously, making the causal relationship with carriage hard to assess. Previous tonsillectomy has been associated with higher carriage rates of N. meningitidis in other studies [31,32], and this association was also seen in the present study. We studied one possible risk factor for meningococcal carriage that has been only sparsely studied before: the use of Swedish snus.…”

Asymptomatic nasopharyngeal bacterial carriage, multi-drug resistance pattern and associated factors among primary school children at Debre Berhan town, North Shewa, Ethiopia

“…In the present study participants who had large family-size showed statistically significant association with the occurrence of with nasopharyngeal bacteria carriage [AOR=2.17, 95%CI 1.24-3.81, P=0.006], which is comparable with studies reported in Indian (P = 0.03) [70], Iran (p=0.044) [62], Ethiopia in Addis Ababa (p=0.006) [7], and Gondar (P= 0.031) [71]. The other factor in the present study that has statically significant association was numbers of rooms (1-2) per house with [AOR=5.88, 95%CI: 1.26-27.57, P=0.024].…”

“…Another independently associated factor statically associated with nasopharyngeal bacteria carriage was children with a history of hospitalization [AOR=4.08, 95%CI 1.45-1.53, P=0.008]. This is in agreement with the studies conducted in Ethiopia, Hawassa (p=0.00) [55], Gondar (P= 0.031) [71]. Common type of nosocomial infection involves invasive devices and procedures (urinary catheters, central lines, mechanical ventilation, or surgery) which might be an important factor for the transmission of respiratory infections and it could have a role in bacteria carriage for healthy individuals [72].…”