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Meningococcal carriage in the African meningitis belt

Caroline L Trotter1, Brian M Greenwood

  • 1Department of Social Medicine, University of Bristol, Bristol, UK. caroline.trotter@bristol.ac.uk

The Lancet. Infectious Diseases
|November 30, 2007
PubMed

Insights

Meningococcal disease epidemics in Africa are unpredictable. Understanding meningococcal carriage is crucial for the success of new conjugate vaccines in controlling the disease.

Area of Science:

  • Epidemiology
  • Vaccinology
  • Public Health

Background:

  • Meningococcal disease epidemics occur periodically in Africa's meningitis belt.
  • New conjugate vaccines aim to control disease by reducing meningococcal carriage and generating herd immunity.
  • Understanding carriage epidemiology is vital for assessing vaccine impact.

Purpose of the Study:

  • To review published studies on meningococcal carriage in the African meningitis belt.
  • To identify factors influencing carriage prevalence and serogroup distribution.
  • To highlight the need for longitudinal carriage studies to evaluate conjugate vaccine impact.

Main Methods:

  • Systematic review of published literature on meningococcal carriage in the African meningitis belt.
  • Analysis of reported carriage prevalence rates and serogroup distributions.
  • Identification and synthesis of factors affecting meningococcal carriage.

Main Results:

  • Carriage prevalence varied widely (3% to over 30%) across studies.
  • Serogroup distribution was also variable.
  • Age, contact with cases, and epidemic status influenced carriage; season and polysaccharide vaccine had minimal effect.

Conclusions:

  • Meningococcal carriage dynamics in Africa are complex and require further investigation.
  • Longitudinal studies are essential for accurately measuring the impact of meningococcal group A conjugate vaccines.
  • Carefully designed carriage studies are needed to guide public health interventions.

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