title: Prevalence, Risk Factors and Molecular Characteristics of Meningococcal Carriage Among Brazilian Adolescents.
abstract: BACKGROUND
  In 2010, introduction of the meningococcal C conjugate vaccine in Brazil for children <2 years provided an immediate reduction in the incidence rates of disease among the age groups targeted for the vaccine, but no early impact was observed in unvaccinated age groups. Knowledge about meningococcal carriage is crucial for improving our understanding of the disease epidemiology and for designing effective vaccination programs. Taking in account the very limited published data currently available describing meningococcal carriage in Brazil, we performed a study to evaluate the prevalence of Neisseria meningitidis carriage among adolescent students.
  
  
  METHODS
  A cross-sectional study was conducted in 2012 to assess the prevalence of meningococcal carriage among a representative sample of 1208 students 11-19 years of age in Campinas, Brazil. Genotypic and phenotypic characterization of isolated carriage strains and the effect of potential risk factors for carriage were also analyzed.
  
  
  RESULTS
  The overall carriage prevalence was 9.9% (95% confidence interval, 8.3-11.8%), with dominance of serogroup C (1.32%), followed by serogroups B (0.99%), E (0.74%), Y (0.49%) and W (0.25%). A lower level of education of the parents was independently associated with a higher risk of carriage. A high diversity of genotypes was found among carriage strains.
  
  
  CONCLUSIONS
  The evidence gathered during this study provides estimates of carriage prevalence in Brazilian adolescents, showing an unusually high dominance of serogroup C. These results have important implications in future strategies to optimize the impact of the current meningococcal C vaccination program in Brazil.
authors.affiliation: From the *Department of Social Medicine, FCM da Santa Casa de São Paulo, São Paulo, Brazil; †Municipal Health Secretariat, Campinas, Brazil; ‡Bacteriology Center, Adolfo Lutz Institute, São Paulo, Brazil; §Bacteriology Center, Adolfo Lutz Institute, Campinas, Brazil; ¶Immunology Center, Adolfo Lutz Institute, São Paulo, Brazil; ‖Center of Epidemiologic Surveillance "Alexandre Vranjac," São Paulo, Brazil; and **Department of Pediatrics, FCM da Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Jose
authors.initials: J
authors.lastname: Cassio de Moraes
authors.forename: Brigina
authors.initials: B
authors.lastname: Kemp
authors.forename: Ana Paula Silva
authors.initials: AP
authors.lastname: de Lemos
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Outeiro Gorla
authors.forename: Eneida Gonçalves
authors.initials: EG
authors.lastname: Lemes Marques
authors.forename: Maria do Carmo
authors.initials: Mdo C
authors.lastname: Ferreira
authors.forename: Claudio
authors.initials: C
authors.lastname: Sacchi
authors.forename: Telma Regina Marques Pinto
authors.initials: TR
authors.lastname: Carvalhanas
authors.forename: Ana Freitas
authors.initials: AF
authors.lastname: Ribeiro
authors.forename: Cleide Marques
authors.initials: CM
authors.lastname: Ferreira
authors.forename: Maristela Marques
authors.initials: MM
authors.lastname: Salgado
authors.forename: Lucila
authors.initials: L
authors.lastname: Fukasawa
authors.forename: Maria Gisele
authors.initials: MG
authors.lastname: Gonçalves
authors.forename: Fabio
authors.initials: F
authors.lastname: Higa
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Angerami
authors.forename: André Ribas
authors.initials: AR
authors.lastname: Freitas
authors.forename: Helena Keico
authors.initials: HK
authors.lastname: Sato
authors.forename: Marco Aurélio Palazzi
authors.initials: MA
authors.lastname: Sáfadi
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D009345:Neisseria meningitidis / Q000235:genetics*; D009960:Oropharynx / Q000382:microbiology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult