Prevalence, Risk Factors and Molecular Characteristics of Meningococcal Carriage Among Brazilian Adolescents

Moraes, José Cássio de; Kemp, Brigina; Lemos, Ana Paula Silva de; Gorla, Maria Cecília Outeiro; Marques, Eneida Gonçalves Lemes; Ferreira, Maria do Carmo; Sacchi, Cláudio Tavares; Carvalhanas, Telma Regina Marques Pinto; Ribeiro, Ana Freitas; Ferreira, Cleide Marques; Salgado, Maristela Marques; Fukasawa, Lucila Okuyama; Gonçalves, Maria Gisele; Higa, Fábio Takenori; Angerami, Rodrigo Nogueira; Freitas, André Ribas; Sato, Helena Keico; Sáfadi, Marco Aurélio Palazzi

doi:10.1097/inf.0000000000000853

Cited by 42 publications

(57 citation statements)

References 27 publications

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“…meningitidis group C was 0.17%. The overall prevalence for adolescents in Salvador was lower than the prevalence (9.9%) observed in a similar study performed in Campinas, Brazil, after introducing the MCC vaccine among children <2 years old [15]. Moreover, our results were similar to those of studies from other Latin American countries, such as Colombia (6.85%) [20] and Chile (6.5%) [21].…”

Section: Discussionsupporting

confidence: 84%

“…On the other hand, even though meningococcal carriage is an age-dependent phenomenon (increasing from 4.5% in infants to 23.7% in 19 year olds and then decreasing to 7.8% in adults over 50 years old [23]), we did not find any age-related difference in the carriage prevalence among adolescents 11–19 years old, results that are similar to those found in Campinas [15]. In addition, even though men are the most prevalent meningococcal carriers worldwide [13], sex was not associated with meningococcal carriage in our study [15, 20].…”

Section: Discussionsupporting

confidence: 68%

“…In addition, even though men are the most prevalent meningococcal carriers worldwide [13], sex was not associated with meningococcal carriage in our study [15, 20]. …”

Section: Discussionmentioning

confidence: 59%

“…The required sample size ( n = 1,200) was based on a hypothetical prevalence of N . meningitidis carriage of 9.9% (as obtained in a study with adolescents in schools in Campinas, Brazil [15], a precision of 2% standard deviation for a 95% confidence interval, and a correction factor for the cluster design effect of 2. However, because we expected that about half of the selected participants would refuse to participate in the study, we invited 2,440 students to participate.…”

Section: Methodsmentioning

confidence: 99%

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Meningococcal Carriage among Adolescents after Mass Meningococcal C Conjugate Vaccination Campaigns in Salvador, Brazil

et al. 2016

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Neisseria meningitidis is a commensal bacterium of the human nasopharynx. In rare cases, it penetrates the mucosa, entering the blood stream and causing various forms of disease. Meningococcal conjugate vaccines can prevent invasive disease not only by direct effect in vaccinated individuals but also by herd protection, preventing acquisition of carriage, which interrupts transmission and leads to protection of unvaccinated persons. In 2010 in Salvador, Brazil, an outbreak of group C meningococcal disease led to a mass meningococcal serogroup C conjugate vaccination drive, targeting those <5 and 10–24 years of age. The present study aimed to estimate the prevalence of and identify factors associated with N. meningitidis carriage among adolescents from Salvador, Brazil, in the post-vaccination period. In spring 2014, we performed a cross-sectional study involving 1,200 public school students aged 11–19 years old. Oropharyngeal swabs were collected to identify N. meningitidis. Of the 59 colonized participants, 36 (61.0%) carried non-groupable N. meningitidis, while genogroup B (11.9%), Y (8.5%), E (6.8%), Z (5.1%), C (3.4%), and W (3.4%) were also detected. The overall prevalence of N. meningitidis carriage was 4.9% (95% confidence interval [CI], 3.6–6.1%); the prevalence of N. meningitidis genogroup C was 0.17% (95% CI, 0.0–0.40%). There was no difference by age. Factors associated with carriage were having only one, shared, bedroom in the household (PR, 2.02; 95% CI, 0.99–4.12, p = 0.05); the mother being the only smoker in the home (PR, 2.48; 95% CI, 1.16–5.29; p = 0.01); and going to pubs/parties more than 5 times/month (PR, 2.61; 95% CI, 1.38–4.92; p = 0.02). Our findings show that the N. meningitidis carriage rate in adolescents from Salvador, Bahia, is low and is potentially influenced by the low prevalence of N. meningitidis genogroup C. However, continued surveillance is important to identify changes in the dynamics of N. meningitidis, including the emergence of diseases due to a non-C serogroup.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 68%

“…In addition, even though men are the most prevalent meningococcal carriers worldwide [13], sex was not associated with meningococcal carriage in our study [15, 20]. …”

Section: Discussionmentioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

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Meningococcal Carriage among Adolescents after Mass Meningococcal C Conjugate Vaccination Campaigns in Salvador, Brazil

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“…The introduction of the MenC vaccine in Brazil in 2010 provided an immediate reduction in incidence rates of MD, especially in those children targeted for vaccination ( Figure 1). Carriage rates in adolescents, in a study performed 2 years after the initiation of the infant immunization program, showed a prevalence of 10%, where serogroups were identified, serogroup C was the most common (1.32%), followed by serogroups B (0.99%), E (0.74%), Y (0.49%), and W (0.25%) [37]. Although plain PSVs offered protection against disease, they did not prevent acquisition of carriage of MenC in the 2010 outbreaks [38], which is why only conjugate vaccines are now used to control outbreaks.…”

Section: Latin Americamentioning

confidence: 99%

The Global Meningococcal Initiative: global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection

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Alarcón

Carlos

et al. 2016

Expert Review of Vaccines

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Introduction: The 2015 Global Meningococcal Initiative (GMI) meeting discussed the global importance of meningococcal disease (MD) and its continually changing epidemiology. Areas covered: Although recent vaccination programs have been successful in reducing incidence in many countries (e.g. Neisseria meningitidis serogroup [Men]C in Brazil, MenA in the African meningitis belt), new clones have emerged, causing outbreaks (e.g. MenW in South America, MenC in Nigeria and Niger). The importance of herd protection was highlighted, emphasizing the need for high vaccination uptake among those with the highest carriage rates, as was the need for boosters to maintain individual and herd protection following decline of immune response after primary immunization. Expert commentary: The GMI Global Recommendations for Meningococcal Disease were updated to include a recommendation to enable access to whole-genome sequencing as for surveillance, guidance on strain typing to guide use of subcapsular vaccines, and recognition of the importance of advocacy and awareness campaigns. ARTICLE HISTORY

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Carriage of Neisseria Meningitidis in Low and Middle Income Countries of the Americas and Asia: A Review of the Literature

2020

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Introduction: Meningococcal colonization, or carriage, can progress to invasive meningococcal disease, a serious public health concern, with rapid progression of disease and severe consequences if left untreated. Information on meningococcal carriage and epidemiology in low/middle income American and Asian countries remains sparse. These data are crucial to ensure that appropriate preventive strategies such as vaccination can be implemented in these regions. The goal of this study was to summarize the Neisseria meningitidis carriage literature in low and middle income countries of the Americas and Asia. Methods: Target countries were categorized as low and middle income according to the International Monetary Fund classification of low income/developing economies and middle income/emerging market economies, respectively. A PubMed search identified Englishlanguage publications that examined carriage in these countries. Studies reporting the epidemiology of N. meningitidis carriage or assessing risk factors for carriage were included. Results: Fourteen studies from the Americas [Brazil (n = 7), Chile (n = 3), and Colombia, Cuba, Mexico, and Paraguay (n = 1 each)] and nine from Asia [China (n = 2), India (n = 3), and Malaysia, Nepal, Philippines, and Thailand (n = 1 each)] were identified; an additional Cuban study from the authors' files was also included. Studies were not identified in many target countries, and substantial diversity was observed among study methodologies, populations, and time periods, thereby limiting comparison between studies. The carriage rate in the Americas ranged from 1.6% to 9.9% and from 1.4% to 14.2% in Asia. Consistent risk factors for carriage were not identified. Conclusions: There is a lack of comprehensive and contemporary information on meningococcal carriage in low and medium income countries of the Americas and Asia. Future Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare. 11962566.

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Prevalence, Risk Factors and Molecular Characteristics of Meningococcal Carriage Among Brazilian Adolescents

Cited by 42 publications

References 27 publications

Meningococcal Carriage among Adolescents after Mass Meningococcal C Conjugate Vaccination Campaigns in Salvador, Brazil

Meningococcal Carriage among Adolescents after Mass Meningococcal C Conjugate Vaccination Campaigns in Salvador, Brazil

The Global Meningococcal Initiative: global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection

Carriage of Neisseria Meningitidis in Low and Middle Income Countries of the Americas and Asia: A Review of the Literature

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