Mbaeyi Sarah, Sampo Emmanuel, Dinanibè Kambiré, Yaméogo Issaka, Congo-Ouédraogo Malika, Tamboura Mamadou, Sawadogo Guetawendé, Ouattara Kalifa, Sanou Mahamadou, Kiemtoré Tanga, Dioma Gerard, Sanon Barnabé, Somlaré Hermann, Kyetega Augustin, Ba Absatou Ky, Aké Flavien, Tarbangdo Félix, Aboua Frederic Acho, Donnou Yvette, Kamaté Idrissa, Patel Jaymin C, Schmink Susanna, Spiller Michael W, Topaz Nadav, Novak Ryan, Wang Xin, Bicaba Brice, Sangaré Lassana, Ouédraogo-Traoré Rasmata, Kristiansen Paul A
National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Hôpital Schiphra Protestant, Ouagadougou, Burkina Faso.
Lancet Infect Dis. 2020 Dec;20(12):1418-1425. doi: 10.1016/S1473-3099(20)30239-5. Epub 2020 Jul 9.
In the first 2 years after a nationwide mass vaccination campaign of 1-29-year-olds with a meningococcal serogroup A conjugate vaccine (MenAfriVac) in Burkina Faso, carriage and disease due to serogroup A Neisseria meningitidis were nearly eliminated. We aimed to assess the long-term effect of MenAfriVac vaccination on meningococcal carriage and herd immunity.
We did four cross-sectional studies of meningococcal carriage in people aged 9 months to 36 years in two districts of Burkina Faso between May 2, 2016, and Nov 6, 2017. Demographic information and oropharyngeal swabs were collected. Meningococcal isolates were characterised using whole-genome sequencing.
Of 14 295 eligible people, 13 758 consented and had specimens collected and laboratory results available, 1035 of whom were meningococcal carriers. Accounting for the complex survey design, prevalence of meningococcal carriage was 7·60% (95% CI 5·67-9·52), including 6·98% (4·86-9·11) non-groupable, 0·48% (0·01-0·95) serogroup W, 0·10% (0·01-0·18) serogroup C, 0·03% (0·00-0·80) serogroup E, and 0% serogroup A. Prevalence ranged from 5·44% (95% CI 4·18-6·69) to 9·14% (6·01-12·27) by district, from 4·67% (2·71-6·64) to 11·17% (6·75-15·59) by round, and from 3·39% (0·00-8·30) to 10·43% (8·08-12·79) by age group. By clonal complex, 822 (88%) of 934 non-groupable isolates were CC192, all 83 (100%) serogroup W isolates were CC11, and nine (69%) of 13 serogroup C isolates were CC10217.
Our results show the continued effect of MenAfriVac on serogroup A meningococcal carriage, for at least 7 years, among vaccinated and unvaccinated cohorts. Carriage prevalence of epidemic-prone serogroup C CC10217 and serogroup W CC11 was low. Continued monitoring of N meningitidis carriage will be crucial to further assess the effect of MenAfriVac and inform the vaccination strategy for future multivalent meningococcal vaccines.
Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.
在布基纳法索对1至29岁人群开展全国性A群脑膜炎球菌结合疫苗（MenAfriVac）大规模接种运动后的头两年里，A群脑膜炎奈瑟菌的携带率和发病率几乎被消除。我们旨在评估MenAfriVac疫苗接种对脑膜炎球菌携带情况和群体免疫的长期影响。
在2016年5月2日至2017年11月6日期间，我们在布基纳法索的两个地区对9个月至36岁的人群进行了四项关于脑膜炎球菌携带情况的横断面研究。收集了人口统计学信息和口咽拭子。使用全基因组测序对脑膜炎球菌分离株进行特征分析。
在14295名符合条件的人群中，13758人同意参与并采集了标本且有实验室结果，其中1035人为脑膜炎球菌携带者。考虑到复杂的调查设计，脑膜炎球菌携带率为7.60%（95%置信区间5.67 - 9.52），包括6.98%（4.86 - 9.11）不可分型、0.48%（0.01 - 0.95）W群、0.10%（0.01 - 0.18）C群、0.03%（0.00 - 0.80）E群，A群为0%。携带率按地区从5.44%（95%置信区间4.18 - 6.69）到9.14%（6.01 - 12.27），按轮次从4.67%（2.71 - 6.64）到11.17%（6.75 - 15.59），按年龄组从3.39%（0.00 - 8.30）到10.43%（8.08 - 12.79）。按克隆复合体分类，934株不可分型分离株中的822株（88%）为CC192，所有83株（100%）W群分离株为CC11，13株C群分离株中的9株（69%）为CC10217。
我们的结果显示，MenAfriVac疫苗对A群脑膜炎球菌携带情况的持续影响至少持续了7年，在接种和未接种疫苗的人群中均如此。易于引发流行的C群CC10217和W群CC11的携带率较低。持续监测脑膜炎奈瑟菌的携带情况对于进一步评估MenAfriVac疫苗的效果以及为未来多价脑膜炎球菌疫苗的接种策略提供信息至关重要。
比尔及梅琳达·盖茨基金会和疫苗免疫全球联盟。
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