title: Burden ofNeisseria meningitidisinfections in China: a systematic review and meta-analysis.
abstract: BACKGROUND
  Neisseria meningitidisis a leading cause of bacterial meningitis and septicemia in children and young adults worldwide. The disease burden associated withN. meningitidisinfections has not been systematically assessed in China. Therefore, we undertook this study to determine the burden of meningococcal disease in China.
  
  
  METHODS
  We performed a systematic review and meta-analysis of articles onN. meningitidisincidence, carriage, seroprevalence and mortality rates in China by searching the Chinese BioMedical Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database and PubMed for publications from January 2005 to Aug 2015.
  
  
  RESULTS
  In total, 50 articles were included in our analysis. The overall incidence of meningococcal disease and associated mortality were estimated to be 1.84 (95% confidence interval (CI) 0.91-3.37) per 100 000 persons per year and 0.33 (95% CI 0.12-0.86) per 100 000 persons per year, respectively.N. meningitidiscarriage rate among the healthy population was estimated to be 2.7% (95% CI 2.0-3.5%). Prevalence of antibodies againstN. meningitidisserogroup A and C were estimated to be 77.3% (95% CI 72.4%-81.6%) and 33.5% (95% CI 27.0%-40.8%), respectively. No studies were found for serogroup specific disease burden.
  
  
  CONCLUSIONS
  The overall incidence of meningococcal disease in China is low. The lower seroprevalence of serogroup C within the population suggests that it may pose a greater risk for meningococcal disease outbreak than serogroup A. The lack of data on serogroup disease burden by age groups suggests the implementation of laboratory based meningococcal surveillance systems are urgently needed in China.
authors.affiliation: Infection Management and Disease Prevention Department, China-Japan Friendship Hospital, Hepingli, Beijing, China.
authors.forename: Yaowen
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Infection Management and Disease Prevention Department, China-Japan Friendship Hospital, Hepingli, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wei
authors.affiliation: Department of Infectious Diseases, China-Japan Friendship Hospital, Hepingli, Beijing, China.
authors.forename: Xinzhen
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Infectious Diseases, China-Japan Friendship Hospital, Hepingli, Beijing, China.
authors.forename: Mai
authors.initials: M
authors.lastname: Han
authors.affiliation: Department of Infectious Diseases, China-Japan Friendship Hospital, Hepingli, Beijing, China.
authors.forename: Lichao
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Sanofi Pasteur, Discovery Drive, Swiftwater, PA, USA.
authors.forename: Moe H
authors.initials: MH
authors.lastname: Kyaw
mesh_terms: D000906:Antibodies / Q000097:blood; D002681:China; D006801:Humans; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D009345:Neisseria meningitidis; D065288:Serogroup
chemical_list: D000906:Antibodies