Mueller Judith E, Yaro Seydou, Madec Yoann, Somda Paulin K, Idohou Régina S, Lafourcade Berthe-Marie Njanpop, Drabo Aly, Tarnagda Zekiba, Sangaré Lassana, Traoré Yves, Fontanet Arnaud, Gessner Bradford D
Agence de Médecine Préventive, Paris, France.
Trop Med Int Health. 2008 Dec;13(12):1543-52. doi: 10.1111/j.1365-3156.2008.02165.x. Epub 2008 Oct 6.
To evaluate risk factors for meningococcal carriage and carriage acquisition in the African meningitis belt, comparing epidemic serogroup A (NmA) to non-epidemic serogroups.
During the non-epidemic meningitis season of 2003, pharyngeal swabs were taken at five monthly visits in a representative population sample (N = 488) of Bobo-Dioulasso, Burkina Faso (age 4-29 years) and analysed by culture. Standardized questionnaires were administered. In 2006, a similar study was performed in 624 individuals (age 1-39 years) during an NmA meningitis epidemic. We evaluated serogroup-specific risk factors for carriage, carriage acquisition and clearance using multivariate logistic and Poisson regression, and a Cox proportional hazard model.
The prevalence of NmA carriage (current or recent pharyngitis or rhinitis) was 16% (31%) vs. 0% (9%) in the epidemic vs. the hyperendemic setting. During the epidemic situation, NmA carriage was significantly associated with recent sore throat (adjusted odds ratio (OR), 3.41) and current rhinitis (OR 2.65). During the non-epidemic meningitis season in 2003, air humidity (20-39% and >or=40%, compared to <20%) during the month before swabbing was significantly and positively associated with carriage acquisition of non-groupable meningococci (OR 2.18 and 1.55) and inversely with carriage clearance (hazard ratio 0.61 and 0.27, respectively).
Respiratory tract infections may increase meningococcal carriage, and thus contribute to epidemic risk, in addition to seasonality in the meningitis belt. Humid climate may favour carriage of unencapsulated meningococci. These findings may help identifying interventions against epidemic and hyperendemic meningococcal meningitis due to non-vaccine serogroups.
评估非洲脑膜炎带中脑膜炎球菌携带及获得携带状态的风险因素，比较流行血清群A（NmA）与非流行血清群。
在2003年非流行脑膜炎季节，对布基纳法索博博迪乌拉索具有代表性的人群样本（N = 488，年龄4 - 29岁）进行了5次月度访视，采集咽拭子并进行培养分析。同时发放标准化问卷。2006年，在一次NmA脑膜炎流行期间，对624名个体（年龄1 - 39岁）进行了类似研究。我们使用多变量逻辑回归和泊松回归以及Cox比例风险模型评估了血清群特异性的携带、获得携带状态和清除携带状态的风险因素。
在流行期与高流行期，NmA携带（当前或近期咽炎或鼻炎）的患病率分别为16%（31%）和0%（9%）。在流行情况下，NmA携带与近期喉咙痛（调整后的优势比（OR）为3.41）和当前鼻炎（OR为2.65）显著相关。在2003年非流行脑膜炎季节，拭子采集前一个月的空气湿度（与<20%相比，分别为20 - 39%和≥40%）与不可分型脑膜炎球菌的携带获得显著正相关（OR分别为2.18和1.55），与携带清除呈负相关（风险比分别为0.61和0.27）。
除脑膜炎带的季节性外，呼吸道感染可能增加脑膜炎球菌携带，从而增加流行风险。潮湿气候可能有利于未包膜脑膜炎球菌的携带。这些发现可能有助于确定针对非疫苗血清群引起的流行性和高流行性脑膜炎球菌性脑膜炎的干预措施。
