title: A Seroepidemiological Study of Serogroup A Meningococcal Infection in the African Meningitis Belt.
abstract: The pattern of epidemic meningococcal disease in the African meningitis belt may be influenced by the background level of population immunity but this has been measured infrequently. A standardised enzyme-linked immunosorbent assay (ELISA) for measuring meningococcal serogroup A IgG antibodies was established at five centres within the meningitis belt. Antibody concentrations were then measured in 3930 individuals stratified by age and residence from six countries. Seroprevalence by age was used in a catalytic model to determine the force of infection. Meningococcal serogroup A IgG antibody concentrations were high in each country but showed heterogeneity across the meningitis belt. The geometric mean concentration (GMC) was highest in Ghana (9.09 μg/mL [95% CI 8.29, 9.97]) and lowest in Ethiopia (1.43 μg/mL [95% CI 1.31, 1.57]) on the margins of the belt. The force of infection was lowest in Ethiopia (λ = 0.028). Variables associated with a concentration above the putative protective level of 2 μg/mL were age, urban residence and a history of recent vaccination with a meningococcal vaccine. Prior to vaccination with the serogroup A meningococcal conjugate vaccine, meningococcal serogroup A IgG antibody concentrations were high across the African meningitis belt and yet the region remained susceptible to epidemics.
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.|Medical Research Council Unit, Fajara, The Gambia.
authors.forename: Olivier
authors.initials: O
authors.lastname: Manigart
authors.affiliation: Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Trotter
authors.affiliation: Public Health England Vaccine Evaluation Unit, Manchester, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Findlow
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Abraham
authors.initials: A
authors.lastname: Assefa
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Wude
authors.initials: W
authors.lastname: Mihret
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Moti Demisse
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Biruk
authors.initials: B
authors.lastname: Yeshitela
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana.
authors.forename: Isaac
authors.initials: I
authors.lastname: Osei
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana.
authors.forename: Abraham
authors.initials: A
authors.lastname: Hodgson
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana.
authors.forename: Stephen Laryea
authors.initials: SL
authors.lastname: Quaye
authors.affiliation: Centre pour les Vaccins en Développement, Bamako, Mali.
authors.forename: Samba
authors.initials: S
authors.lastname: Sow
authors.affiliation: Centre pour les Vaccins en Développement, Bamako, Mali.
authors.forename: Mamadou
authors.initials: M
authors.lastname: Coulibaly
authors.affiliation: Centre pour les Vaccins en Développement, Bamako, Mali.
authors.forename: Kanny
authors.initials: K
authors.lastname: Diallo
authors.affiliation: Centre pour les Vaccins en Développement, Bamako, Mali.
authors.forename: Awa
authors.initials: A
authors.lastname: Traore
authors.affiliation: Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Collard
authors.affiliation: Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger.
authors.forename: Rahamatou
authors.initials: R
authors.lastname: Moustapha Boukary
authors.affiliation: Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger.
authors.forename: Oumarou
authors.initials: O
authors.lastname: Djermakoye
authors.affiliation: Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger.
authors.forename: Ali Elhaji
authors.initials: AE
authors.lastname: Mahamane
authors.affiliation: Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Jusot
authors.affiliation: Institut de Recherche pour le Développement, Dakar, Senegal.
authors.forename: Cheikh
authors.initials: C
authors.lastname: Sokhna
authors.affiliation: Institut de Recherche pour le Développement, Dakar, Senegal.
authors.forename: Serge
authors.initials: S
authors.lastname: Alavo
authors.affiliation: Institut de Recherche pour le Développement, Dakar, Senegal.
authors.forename: Souleymane
authors.initials: S
authors.lastname: Doucoure
authors.affiliation: Institut de Recherche pour le Développement, Dakar, Senegal.
authors.forename: El Hadj
authors.initials: el H
authors.lastname: Ba
authors.affiliation: Institut de Recherche pour le Développement, Dakar, Senegal.
authors.forename: Mariétou
authors.initials: M
authors.lastname: Dieng
authors.affiliation: Institut de Recherche pour le Développement, Dakar, Senegal.
authors.forename: Aldiouma
authors.initials: A
authors.lastname: Diallo
authors.affiliation: Centre de Support en Santé International (CSSI), N'Djamena, Chad.
authors.forename: Doumagoum Moto
authors.initials: DM
authors.lastname: Daugla
authors.affiliation: Department of Community Medicine, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: Babatunji
authors.initials: B
authors.lastname: Omotara
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chandramohan
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Musa
authors.initials: M
authors.lastname: Hassan-King
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Nascimento
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Arouna
authors.initials: A
authors.lastname: Woukeu
authors.affiliation: Public Health England Vaccine Evaluation Unit, Manchester, United Kingdom.
authors.forename: Ray
authors.initials: R
authors.lastname: Borrow
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: James M
authors.initials: JM
authors.lastname: Stuart
authors.affiliation: Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007156:Immunologic Memory; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification / Q000276:immunology / Q000472:pathogenicity; D016036:Seroepidemiologic Studies; D065288:Serogroup; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D022401:Meningococcal Vaccines