Serogroup-specific meningococcal carriage by age group: a systematic review and meta-analysis

Abstract

ObjectiveNeisseria meningitidiscarriage prevalence has known variation across the lifespan, but it is unclear whether carriage varies among meningococcal capsular groups. Therefore, we aimed to characterise group-specific meningococcal carriage by age group and world region from 2007 to 2016.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Global Health Database, WHO Global Health Library, Web of Science, Current Contents Connects, China National Knowledge Infrastructure and Wanfang were systematically searched. Database searches were conducted through July 2018 and Google Scholar forward searches of included studies were conducted through August 2018. References of included studies and relevant conference abstracts were also searched to identify additional articles for inclusion.Eligibility criteriaStudies were eligible for inclusion if they reported capsular group-specific meningococcal carriage in a healthy population of a specified age group and geographical region. For this review, only studies conducted between 2007 and 2016 were included.Data extraction and synthesisData were independently extracted by two authors into Microsoft Access. Studies were assessed for risk of bias using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Studies eligible for inclusion in quantitative analyses by pre-specified age groups were pooled using random effects meta-analyses. Results are reported by capsular group, age group and WHO region. Where meta-analyses were not appropriate, study results were discussed narratively.Results7511 articles were identified and 65 were eligible for inclusion. Adolescents and young adults were the focus of many studies (n=24), especially in the Americas and Europe. Studies from China and Africa, typically, included data from a wider age range. The overall carriage prevalence varied markedly by age group and region. Based on the available data, 21 studies were included in meta-analyses reporting serogroup carriage for: all ages in Africa, 18–24-year olds in the Americas, and 11–17 and 18–24-year olds in Europe. Capsular groups W, X, Y and ‘other’ (non-ABCWXY, including non-groupable) were the most prevalent in Africa, and 5–17-year olds had higher carriage prevalence than other age groups. ‘Other’ serogroups (11.5%, 95% CI 1.6% to 16.1%) were the most common among 18–24-year olds from the Americas. In Europe, 18–24-year old were carriers more frequently than 11–17-year olds, and groups B (5.0%, 95% CI 3.0% to 7.5%), Y (3.9%, 95% CI 1.3% to 7.8%) and ‘other’ (6.4%, 95% CI 3.1% to 10.8%) were the most commonly carried in the older age group.ConclusionsOf the age groups included in the analysis, carriage patterns by age were similar across capsular groups within a region but differed between regions. Data gaps remain for age- and capsular group-specific carriage in many regions, especially in the Eastern Mediterranean and South-East Asia. As such, clear and robust conclusions about the variation of capsular group-specific carriage by age group and WHO region were unable to be determined.PROSPERO registration numberCRD42017074671.

The Burden of Invasive Vaccine-Preventable Diseases in Adults in the Middle East and North Africa (MENA) Region

“…In addition, some consistencies with epidemiological data from other regions were noted. For instance, the limited data on meningococcal carriage that were identified are generally consistent with publications of other countries outside of the MENA region, with carriage rates between 1.4 and 14.2% reported across all ages in low-and middle-income countries of the Americas and Asia and up to 2% in Africa CAP community-acquired pneumonia, CFR case fatality rate, CSF cerebrospinal fluid, Hib H. influenzae type B, PCR polymerase chain reaction [71,72]. Additionally, studies from western regions and sub-Saharan Africa have also reported an association between smoking and carriage [73][74][75].…”

Detection ofNeisseria meningitidisin Saliva and Oropharyngeal Samples from College Students

“…Serogroup A was not detected in our study, its circulation appears to be limited in the Netherlands [15,28]. The most prevalent genogroup among carriers was B. Genogroups B and Y have both been described to be most commonly detected genogroups among young adults [29].…”

Prevalence of Therapeutic use of Opioids in Chronic non-Cancer Pain Patients and Associated Factors: A Systematic Review and Meta-Analysis

“…Each item was assessed as “yes,” “no,” “unclear” or “not applicable.” For standardization, “yes” was considered to imply a low risk of bias, and “no” and “unclear” a high risk of bias. Since there is not a standard classification for the “Critical Appraisal Checklist for Studies Reporting Prevalence Data from the Joanna Briggs Institute,” some systematic reviews were consulted to guide our classification ( Porto De Toledo et al, 2017 ; Bett et al, 2019 ; Peterson et al, 2019 ). A study was considered to have a low risk of bias (i.e., high-quality study) when it accumulated at least seven items answered as “yes” and a moderate risk of bias when the study reached 4–6 “yes.” Any disagreements regarding the suitability of a study were resolved by a third author (AS).…”