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© Research
Publication : The Journal of infectious diseases

Study of a localized meningococcal meningitis epidemic in Burkina Faso: incidence, carriage, and immunity

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in The Journal of infectious diseases - 12 Oct 2011

Mueller JE, Yaro S, Njanpop-Lafourcade BM, Drabo A, Idohou RS, Kroman SS, Sanou O, Diagbouga S, Traoré Y, Sangaré L, Borrow R, Gessner BD

Link to Pubmed [PMID] – 21998478

J. Infect. Dis. 2011 Dec;204(11):1787-95

BACKGROUND: To better understand localized meningococcal meningitis epidemics, we evaluated a serogroup A (NmA) epidemic in Burkina Faso by surveillance, carriage, and seroprevalence studies.

METHODS: During March-April 2006, cerebrospinal fluid samples from patients suspected to have meningitis in 3 epidemic villages were analyzed by culture or polymerase chain reaction. We assessed meningococcal carriage and serogroup-specific serum bactericidal antibody titers with baby rabbit complement (rSBA) in a representative population sample (N = 624; age range, 1-39 years). A serogroup A/C polysaccharide vaccine campaign occurred in parallel.

RESULTS: Cumulative incidence of Nm meningitis was 0.45% and varied among villages (0.08%-0.91%). NmA carriage prevalence was 16% without variation by vaccination status. NmA carriage and anti-NmA seroprevalence varied by village and incidence. In the 2 villages with highest incidence and seroprevalence, presence of rSBA titers ≥8 was associated with NmA carriage (odds ratio [OR], 9.33 [95% confidence interval {CI}, 1.90-45.91]) and vaccination ≤4 days earlier (OR, 0.10 [95% CI, .03-.32]). Visibly purulent or Nm meningitis was significantly associated with recent flulike symptoms and exposure to kitchen smoke (risk ratios >15).

CONCLUSIONS: A surge of NmA carriage may be involved in the development of meningococcal epidemics and rapidly increase anti-NmA seroprevalence. Flulike infection and kitchen smoke may contribute to the strength of epidemics.

http://www.ncbi.nlm.nih.gov/pubmed/21998478