Disease Dynamics Unit, Department of Veterinary Medicine,University of Cambridge,Madingley Road, Cambridge CB3 0ES, England,UK.
WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health,Oslo,Norway.
Epidemiol Infect. 2019 Jan;147:e228. doi: 10.1017/S0950268819001134.
Meningococcal carriage dynamics drive patterns of invasive disease. The distribution of carriage by age has been well described in Europe, but not in the African meningitis belt, a region characterised by frequent epidemics of meningitis. We aimed to estimate the age-specific prevalence of meningococcal carriage by season in the African meningitis belt. We searched PubMed, Web of Science, the Cochrane Library and grey literature for papers reporting carriage of Neisseria meningitidis in defined age groups in the African meningitis belt. We used a mixed-effects logistic regression to model meningococcal carriage prevalence as a function of age, adjusting for season, location and year. Carriage prevalence increased from low prevalence in infants (0.595% in the rainy season, 95% CI 0.482-0.852%) to a broad peak at age 10 (1.94%, 95% CI 1.87-2.47%), then decreased in adolescence. The odds of carriage were significantly increased during the dry season (OR 1.5 95% CI 1.4-1.7) and during outbreaks (OR 6.7 95% CI 1.6-29). Meningococcal carriage in the African meningitis belt peaks at a younger age compared to Europe. This is consistent with contact studies in Africa, which show that children 10-14 years have the highest frequency of contacts. Targeting older children in Africa for conjugate vaccination may be effective in reducing meningococcal transmission.
脑膜炎球菌带菌动态驱动侵袭性疾病的模式。年龄相关带菌率在欧洲已经得到很好的描述，但在非洲脑膜炎带，这一经常发生脑膜炎流行的地区，却没有得到描述。我们旨在估计非洲脑膜炎带的季节性年龄特异性脑膜炎球菌带菌率。我们在 PubMed、Web of Science、Cochrane 图书馆和灰色文献中搜索了报告在非洲脑膜炎带特定年龄组中脑膜炎奈瑟菌带菌情况的论文。我们使用混合效应逻辑回归模型，将脑膜炎球菌带菌率作为年龄、季节、位置和年份的函数进行建模。带菌率从婴儿期的低流行率（雨季为 0.595%，95%CI 0.482-0.852%）逐渐升高到 10 岁时的广泛高峰（1.94%，95%CI 1.87-2.47%），然后在青春期下降。在旱季（OR 1.5，95%CI 1.4-1.7）和爆发期间（OR 6.7，95%CI 1.6-29），带菌的可能性显著增加。与非洲的接触研究一致，非洲脑膜炎带的脑膜炎球菌带菌率在较年轻的年龄达到高峰，在非洲，10-14 岁的儿童接触频率最高。在非洲针对年龄较大的儿童进行结合疫苗接种可能有效减少脑膜炎球菌传播。
