Trotter Caroline L, Greenwood Brian M
Department of Social Medicine, University of Bristol, Bristol, UK.
Lancet Infect Dis. 2007 Dec;7(12):797-803. doi: 10.1016/S1473-3099(07)70288-8.
In the African meningitis belt, epidemics of meningococcal disease occur periodically, although unpredictably, every few years. These epidemics continue to cause havoc but new efforts to control the disease, through the use of conjugate vaccines, are being made. Conjugate vaccines are likely to reduce meningococcal carriage, thus generating herd immunity, but to understand their potential impact we need to know more about the epidemiology of meningococcal carriage in Africa. We review published studies of meningococcal carriage in the African meningitis belt. A wide range of carriage prevalences has been reported, from 3% to over 30%, and the serogroup distribution has been variable. Factors influencing carriage include age, contact with a case, and the epidemic/endemic situation; however, season and immunisation with polysaccharide vaccine have little effect. Since the dynamics of carriage within a population are complex, longitudinal carriage studies are of great value; however, few such studies have been done. Carefully designed carriage studies are needed to measure and interpret the impact of meningococcal group A conjugate vaccines in Africa.
在非洲脑膜炎带，脑膜炎球菌病的流行每隔几年就会周期性发生，尽管无法预测。这些疫情继续造成严重破坏，但目前正在通过使用结合疫苗对该疾病进行新的防控努力。结合疫苗可能会减少脑膜炎球菌的携带，从而产生群体免疫，但为了了解其潜在影响，我们需要更多地了解非洲脑膜炎球菌携带的流行病学情况。我们回顾了非洲脑膜炎带关于脑膜炎球菌携带情况的已发表研究。报告的携带率范围很广，从3%到超过30%，血清群分布也各不相同。影响携带的因素包括年龄、与病例的接触以及流行/地方病情况；然而，季节和多糖疫苗免疫的影响很小。由于人群中携带的动态情况复杂，纵向携带研究具有很大价值；然而，此类研究做得很少。需要精心设计携带研究来衡量和解释A群脑膜炎球菌结合疫苗在非洲的影响。
