title: Association of respiratory tract infection symptoms and air humidity with meningococcal carriage in Burkina Faso.
abstract: OBJECTIVE
  To evaluate risk factors for meningococcal carriage and carriage acquisition in the African meningitis belt, comparing epidemic serogroup A (NmA) to non-epidemic serogroups.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Agence de Médecine Préventive, Paris, France. jmueller@aamp.org
authors.forename: Judith E
authors.initials: JE
authors.lastname: Mueller
authors.forename: Seydou
authors.initials: S
authors.lastname: Yaro
authors.forename: Yoann
authors.initials: Y
authors.lastname: Madec
authors.forename: Paulin K
authors.initials: PK
authors.lastname: Somda
authors.forename: Régina S
authors.initials: RS
authors.lastname: Idohou
authors.forename: Berthe-Marie Njanpop
authors.initials: BM
authors.lastname: Lafourcade
authors.forename: Aly
authors.initials: A
authors.lastname: Drabo
authors.forename: Zekiba
authors.initials: Z
authors.lastname: Tarnagda
authors.forename: Lassana
authors.initials: L
authors.lastname: Sangaré
authors.forename: Yves
authors.initials: Y
authors.lastname: Traoré
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso / Q000453:epidemiology; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D006813:Humidity; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008589:Meningococcal Infections / Q000635:transmission*; D038381:Neisseria meningitidis, Serogroup A; D012141:Respiratory Tract Infections / Q000382:microbiology*; D012307:Risk Factors; D012703:Serotyping; D055815:Young Adult