Variations in Neisseria meningitidis carriage by socioeconomic status: a cross-sectional study.
BACKGROUND
Deprivation is associated with an increased risk of invasive Neisseria meningitidis disease, but little is known about the relationship between deprivation and asymptomatic carriage of N. meningitidis. This analysis was conducted to examine the relationship between meningococcal carriage and deprivation.


METHODS
As part of a rapid meningococcal carriage prevalence study conducted in West Cumbria to investigate an apparent cluster of invasive meningococcal disease, data were collected on lifestyle and social factors, including area-level indicators of socioeconomic status, to identify factors associated with meningococcal carriage.


RESULTS
In a multivariable log binomial regression model adjusted for age, lower socioeconomic status was significantly associated with higher prevalence of meningococcal carriage. A 1-unit increase in Index of Multiple Deprivation (2010) score was associated with a 1.7% increase in meningococcal carriage prevalence (95% confidence interval 0.3-3.0%). Age was the only significant predictor of carriage of Neisseria lactamica.


CONCLUSIONS
Living in a deprived area is associated with increased carriage of Group B meningococcus. Deprivation is an important factor to consider in the evaluation of the effectiveness and cost-effectiveness of the introduction of new meningococcal B vaccines and the development and implementation of immunization policies. Further work is required to understand whether deprivation has an effect on meningococcal carriage through other factors such as smoking.
PHE Field Epidemiology Service, Liverpool L1 1JF, UK.
P R
PR
Cleary
NHS Cumbria, Penrith, Cumbria CA11 8HX, UK.
N
N
Calvert
Cumbria and Lancashire Public Health England Centre, Chorley PR7 1NY, UK.
S
S
Gee
North Cumbria University Hospitals Whitehaven, Cumbria CA28 8JG, UK.
C
C
Graham
PHE Meningococcal Reference Unit, Public Health England (PHE), Manchester M13 9WL, UK.
S
S
Gray
PHE Meningococcal Reference Unit, Public Health England (PHE), Manchester M13 9WL, UK.
E
E
Kaczmarski
NHS Cumbria, Penrith, Cumbria CA11 8HX, UK.
J
J
Morphet
NHS Cumbria, Penrith, Cumbria CA11 8HX, UK.
L
L
Murphy
Public Health England Centre for Infection Disease Surveillance and Control, London NW9 5EQ, UK.
N
N
Verlander
Cumbria and Lancashire Public Health England Centre, Chorley PR7 1NY, UK.
T
T
Wood
PHE Meningococcal Reference Unit, Public Health England (PHE), Manchester M13 9WL, UK.
R
R
Borrow
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology*; D008875:Middle Aged; D009345:Neisseria meningitidis; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D064890:Social Determinants of Health / Q000706:statistics & numerical data; D055815:Young Adult
communicable diseases; epidemiology; social determinants