Meningococcal carriage by age: a systematic review and meta-analysis

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07:47

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Published on: February 15, 2013

Hannah Christensen1, Margaret May, Leah Bowen

  • 1School of Social and Community Medicine, University of Bristol, Bristol, UK. hannah.christensen@bristol.ac.uk

The Lancet. Infectious Diseases
|November 16, 2010
PubMed
Abstract

Insights

Meningococcal carriage prevalence peaks in 19-year-olds at 23.7% and declines with age. Understanding this age-specific carriage of Neisseria meningitidis is crucial for disease epidemiology.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • Neisseria meningitidis causes meningitis and septicaemia.
  • Most infections result in asymptomatic carriage, not disease.
  • Previous carriage studies lacked comprehensive age-group assessments.

Purpose of the Study:

  • To estimate the age-specific prevalence of meningococcal carriage.
  • To provide data for understanding meningococcal infection epidemiology and transmission.

Main Methods:

  • Systematic literature search of Embase, Medline, Web of Science, Cochrane Library, and grey literature.
  • Mixed-effects logistic regression with natural cubic splines to model carriage prevalence by age.
  • Analysis included population type, swab method, plating time, plate type, and study decade as fixed effects; country and study as random effects.

Main Results:

  • Carriage prevalence increased from 4.5% in infants to a peak of 23.7% in 19-year-olds.
  • Prevalence decreased to 7.8% in 50-year-olds.
  • Delayed swab plating significantly reduced the odds of positive carriage detection (OR 0.46).

Conclusions:

  • This study offers comprehensive age-specific estimates of meningococcal carriage prevalence.
  • Findings are vital for informing the epidemiology and transmission dynamics of Neisseria meningitidis infections.
  • Highlights the importance of standardized sample handling for accurate carriage detection.

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