Nasopharyngeal carriage and risk factors of major meningitis pathogens among asymptomatic healthcare workers in paediatric units in Benin, with serogroup distribution of Neisseria meningitidis.

BACKGROUND

Healthcare workers in paediatric settings are in close contact with vulnerable children and may serve as reservoirs and vectors for the transmission of respiratory pathogens such as , , and . In the African meningitis belt, data on asymptomatic carriage of these pathogens among healthcare workers remain scarce. This study aimed to assess the nasopharyngeal carriage of these three major meningitis-associated bacteria among paediatric healthcare personnel in Benin.

METHODS

A cross-sectional study was conducted from September 2023 to December 2024 among 221 healthcare workers working in paediatric and neonatology units. Nasopharyngeal swabs were collected and analysed using quantitative real-time Polymerase Chain Reaction to detect (lytA), (sodC), and (hpd3), as well as to characterise serogroups and detect type b. Sociodemographic and clinical data were collected through a structured questionnaire. Associations between participant characteristics and pathogen carriage were assessed using chi-square tests and binary logistic regression, with a significance threshold set at  < 0.05.

RESULTS

The nasopharyngeal carriage prevalence was 24.4% (54/221) for , 11.8% (26/221) for , and 10.0% (22/221) for . Among the meningococcal carriers, 8 (36.4%) carried serogroup Y, 3 (13.6%) serogroup X, and 1 (4.5%) serogroup A. The remaining positive samples did not belong to any of the major vaccine-targeted serogroups (A, B, C, W, X, Y). None of the -positive samples were of serotype b. Pneumococcal carriage was significantly associated with younger age (18–35 years), and residence within the meningitis belt ( < 0.05). Similarly, carriage showed a significant association with residence in the meningitis belt. In contrast, no significant association was observed between carriage and any of the variables assessed.

CONCLUSION

Our findings reveal a substantial carriage of meningitis-related pathogens among paediatric healthcare workers, notably , and . The predominance of non-vaccine serogroups (Y and X) and the absence of b suggest the need for expanded molecular surveillance and reconsideration of vaccine strategies targeting healthcare workers. These results emphasize the importance of infection prevention and control measures measures in paediatric care settings.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12879-025-11492-3.