Prevalence and epidemiology of meningococcal carriage in Southern Ethiopia prior to implementation of MenAfriVac, a conjugate vaccine.
Neisseria meningitidis colonizes humans and transmits mainly by asymptomatic carriage. We sought to determine the prevalence and epidemiology of meningococcal carriage in Ethiopia prior to the introduction of MenAfriVac, a serogroup A meningococcal conjugate vaccine.



A cross-sectional meningococcal carriage study was conducted in Arba Minch, southern Ethiopia. A total of 7479 oropharyngeal samples were collected from 1 to 29 year old volunteers, between March and October, 2014. The swabs were cultured for N. meningitidis and Neisseria lactamica in Ethiopia. N. meningitidis isolates were confirmed and characterized by their serogroup, sequence type (ST) and PorA:FetA profile in Norway.



Overall carriage prevalence was 6.6 %. There was no significant difference in overall carriage between male (6.7 %) and female (6.4 %) participants. Highest carriage prevalence (10.9 %) for females was found in the 15-19 years of age, while prevalence among males was highest (11.3 %) in the 20-24 age group. Non-groupable isolates dominated (76.4 %), followed by serogroups X (14.0 %) and W (5.9 %) isolates. No serogroup A was found. Most non-groupable isolates were ST-192. Serogroup W isolates were assigned to the ST-11 clonal complex, and serogroup X isolates to the ST-181 and ST-41/44 clonal complexes. Overall carriage prevalence of N. lactamica was 28.1 %. Carriage of N. meningitidis and N. lactamica varied depending on age and geographic area, but there was no association between carriage of the two species.



Epidemic strains of serogroups W and X were circulating in this area of Ethiopia. As no serogroup A was found among the carriage isolates the immediate impact of mass-vaccination with MenAfriVac on transmission of N. meningitidis in this population is expected to be marginal.
WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
Guro K
GK
Bårnes
WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.
Paul A
PA
Kristiansen
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Demissew
D
Beyene
Arba Minch College of Health Sciences, Arba Minch, Ethiopia.
Bereket
B
Workalemahu
Arba Minch General Hospital, Arba Minch, Ethiopia.
Paulos
P
Fissiha
College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Behailu
B
Merdekios
Department of Methodology Research and Analysis, Norwegian Institute of Public Health, Oslo, Norway.
Jon
J
Bohlin
Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland.
Marie-Pierre
MP
Préziosi
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Abraham
A
Aseffa
WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway. dominique.caugant@fhi.no.|Faculty of Medicine, University of Oslo, Oslo, Norway. dominique.caugant@fhi.no.
Dominique A
DA
Caugant
D000293:Adolescent; D000328:Adult; D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D032541:Mass Vaccination; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D015995:Prevalence; D018074:Vaccines, Conjugate / Q000008:administration & dosage*; D055815:Young Adult
C573970:MenAfriVac; D022401:Meningococcal Vaccines; D018074:Vaccines, Conjugate
Carriage; Ethiopia; MLST; MenAfriVac; Meningitis belt; Neisseria lactamica; Neisseria meningitidis