title: Study of a localized meningococcal meningitis epidemic in Burkina Faso: incidence, carriage, and immunity.
abstract: BACKGROUND
  To better understand localized meningococcal meningitis epidemics, we evaluated a serogroup A (NmA) epidemic in Burkina Faso by surveillance, carriage, and seroprevalence studies.
  
  
  METHODS
  During March-April 2006, cerebrospinal fluid samples from patients suspected to have meningitis in 3 epidemic villages were analyzed by culture or polymerase chain reaction. We assessed meningococcal carriage and serogroup-specific serum bactericidal antibody titers with baby rabbit complement (rSBA) in a representative population sample (N = 624; age range, 1-39 years). A serogroup A/C polysaccharide vaccine campaign occurred in parallel.
  
  
  RESULTS
  Cumulative incidence of Nm meningitis was 0.45% and varied among villages (0.08%-0.91%). NmA carriage prevalence was 16% without variation by vaccination status. NmA carriage and anti-NmA seroprevalence varied by village and incidence. In the 2 villages with highest incidence and seroprevalence, presence of rSBA titers ≥8 was associated with NmA carriage (odds ratio [OR], 9.33 [95% confidence interval {CI}, 1.90-45.91]) and vaccination ≤4 days earlier (OR, 0.10 [95% CI, .03-.32]). Visibly purulent or Nm meningitis was significantly associated with recent flulike symptoms and exposure to kitchen smoke (risk ratios >15).
  
  
  CONCLUSIONS
  A surge of NmA carriage may be involved in the development of meningococcal epidemics and rapidly increase anti-NmA seroprevalence. Flulike infection and kitchen smoke may contribute to the strength of epidemics.
authors: Agence de Médecine Préventive, Paris, France. judith.mueller@ehesp.fr
authors: Judith E
authors: JE
authors: Mueller
authors: Seydou
authors: S
authors: Yaro
authors: Berthe-Marie
authors: BM
authors: Njanpop-Lafourcade
authors: Aly
authors: A
authors: Drabo
authors: Régina S
authors: RS
authors: Idohou
authors: Sita S
authors: SS
authors: Kroman
authors: Oumarou
authors: O
authors: Sanou
authors: Serge
authors: S
authors: Diagbouga
authors: Yves
authors: Y
authors: Traoré
authors: Lassana
authors: L
authors: Sangaré
authors: Raymond
authors: R
authors: Borrow
authors: Bradford D
authors: BD
authors: Gessner
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003296:Cooking; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000276:immunology* / Q000517:prevention & control; D038381:Neisseria meningitidis, Serogroup A / Q000276:immunology*; D015995:Prevalence; D012906:Smoke; D014611:Vaccination; D055815:Young Adult
chemical_list: D012906:Smoke