Nasal carriage rate and antibiotic susceptibility pattern of Neisseria meningitidis in healthy Ethiopian children and adolescents: A cross-sectional study

Abstract

BackgroundCommunity nasal meningococcal carriage rates are high across Africa. Meningococcal infections are major causes of morbidity and mortality in the continent; especially among children and adolescents. This study aimed to determine the prevalence of nasal carriage and antibiotic susceptibilities of meningococcal isolates from healthy Ethiopian children and adolescents.MethodA cross-sectional study was conducted in one of the sub-cities of Addis Ababa, Ethiopia. Nasal swabs were collected and processed for identification, serogrouping and testing susceptibilities for three antibiotics using standard microbiological techniques. Data on epidemiologic risk factors were collected using a structured questionnaire and the magnitude of their association with carriage was assessed using bivariate and multivariate analysis.ResultA total of 240 samples were collected (115 from males and 125 from females). The mean age of study participants was 11.1 years. The prevalence of nasal carriage for Neisseria meningitidis was 20.4% (49/240). Carriage was significantly higher among children living under crowded conditions (OR 1.268; 95% CI: 1.186–1.355; p = 0.006). The predominant serogroups were W135–20/49 isolates (40.8%) and C—12/49 isolates (24.5%) and 83.7% of meningococci were sensitive for Ciprofloxacin. In contrast, isolates showed high resistance to Ceftriaxone (69.4%) while only 4.2% were sensitive for Penicillin. Multi-drug resistance was documented for 14.3% of the isolates.ConclusionsMeningococcal carriage rate was found to be high with higher rates associated with children and adolescents living in crowded living conditions. Predominant isolates were of serogroup W135 and C and the isolates showed marked susceptibility to Ciprofloxacin and resistance to Ceftriaxone and Penicillin.

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

“…In contrast, our study had less carriage rate compared to three local studies conducted at Gondar university hospital (2019 CSF samples) in the year 2011 to 2013 with 18.4% prevalence [24], Addis Ababa (240 nasal swabs) with 20.4% carriage rate [8] and bacterial meningitis surveillance in Ethiopia, 2012-2013 (139 CSF samples) with 19.4% prevalence rate [25].…”

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

“…Twenty papers were identified which described meningococcal carriage surveys conducted in nine African meningitis belt countries and reported since 2007 [4][5][6][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Sixteen of these surveys were conducted prior to the deployment of the group A meningococcal conjugate vaccine (MenAfriVac â ).…”

“…Risk factors for carriage of N. meningitidis. Six studies conducted by independent groups of investigators reported on risk factors for the prevalence of pharyngeal carriage of N. meningitidis and one study investigated risk factors for acquisition (Table 2) [6,9,18,22,23]. Age was a strong risk factor for carriage, with the prevalence of carriage peaking in those aged 5-14 years in nearly all surveys.…”

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

“…In Ethiopia, a major epidemic was recorded in 2001with 6964 cases and 330 deaths followed by another epidemic during 2003-2004 with 3326 cases and 160 deaths from all regions of the country [7]. The study conducted in Addis Ababa, Ethiopia showed that the prevalence of N. meningitidis among elementary school children was 20.4% [8].…”