title: The prevalence, serogroup distribution and risk factors of meningococcal carriage in adolescents and young adults in Turkey.
abstract: The serogroup epidemiology of invasive meningococcal disease (IMD), which varies considerably by geographic region and immunization schedule, changes continuously. Meningococcal carriage data are crucial for assessing IMD epidemiology and designing f potential vaccination strategies. Meningococcal seroepidemiology in Turkey differs from that in other countries: serogroups W and B are the predominant strains for IMD during childhood, whereas no serogroup C cases were identified over the last 10 y and no adolescent peak for IMD was found. There is a lack of data on meningococcal carriage that represents the whole population. The aims of this multicenter study (12 cities in Turkey) were to evaluate the prevalence of Neisseria meningitidis carriage, the serogroup distribution and the related risk factors (educational status, living in a dormitory or student house, being a household contact with Hajj pilgrims, smoking, completion of military service, attending bars/clubs) in 1518 adolescents and young adults aged 10-24 y. The presence of N. meningitidis DNA was tested, and a serogroup analysis was performed using polymerase chain reaction. The overall meningococcal carriage rate was 6.3% (n = 96) in the study population. A serogroup distribution of the 96 N. meningitidis strains isolated from the nasopharyngeal specimens revealed serogroup A in 5 specimens (5.2%), serogroup B in 9 specimens (9.4%), serogroup W in 64 specimens (66.6%), and serogroup Y in 4 specimens (4.2%); 14 were classified as non-grouped (14.4%). No serogroup C cases were detected. The nasopharyngeal meningococcal carriage rate was 5% in the 10-14 age group, 6.4% in the 15-17 age-group, and 4.7% in the 18-20 age group; the highest carriage rate was found in the 21-24 age group (9.1%), which was significantly higher than those of the other age groups (p < 0.05). The highest carriage rate was found in 17-year-old adolescents (11%). The carriage rate was higher among the participants who had had close contact with Hajj/Umrah pilgrims (p < 0.01) or a history of upper respiratory tract infections over the past 3 months (p < 0.05). The nasopharyngeal carriage rate was 6.3% among adolescents and young adults in Turkey and was similar to the recent rates observed in the same age groups in other countries. The most prevalent serogroup was W, and no serogroup C cases were found. In conclusion, the present study found that meningococcal carriage reaches its peak level by age 17, the highest carriage rate was found in 21 - to 24 - year-olds and the majority of the carriage cases were due to serogroup W. Adolescents and young adult carriers seem to be a potential reservoir for the disease, and further immunization strategies, including adolescent immunization, may play a role in the control of IMD.
authors.affiliation: a Eskisehir Osmangazi University Faculty of Medicine , Department of Pediatrics , Eskisehir , Turkey.
authors.forename: Rahmi Tuna
authors.initials: RT
authors.lastname: Tekin
authors.affiliation: a Eskisehir Osmangazi University Faculty of Medicine , Department of Pediatrics , Eskisehir , Turkey.
authors.forename: Ener Cagri
authors.initials: EC
authors.lastname: Dinleyici
authors.affiliation: b Hacettepe University Faculty of Medicine , Pediatric Infectious Disease Unit , Ankara , Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ceyhan
authors.affiliation: c Okmeydanı Training and Research Hospital, Pediatric Infectious Disease Unit , Istanbul , Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Karbuz
authors.affiliation: d Istanbul University Istanbul Faculty of Medicine, Pediatric Infectious Disease Unit , Istanbul , Turkey.
authors.forename: Nuran
authors.initials: N
authors.lastname: Salman
authors.affiliation: d Istanbul University Istanbul Faculty of Medicine, Pediatric Infectious Disease Unit , Istanbul , Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sutçu
authors.affiliation: e Ege University Faculty of Medicine, Pediatric Infectious Disease Unit , Izmir , Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kurugol
authors.affiliation: f Muratpasa 1st Caybasi Family Practice Center , Antalya , Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Balliel
authors.affiliation: g Sanlıurfa Children Hospital , Sanliurfa , Turkey.
authors.forename: Melda
authors.initials: M
authors.lastname: Celik
authors.affiliation: h Uludag University Faculty of Medicine , Pediatric Infectious Disease Unit , Bursa , Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hacimustafaoglu
authors.affiliation: i Mersin University Faculty of Medicine , Pediatric Infectious Disease Unit , Mersin , Turkey.
authors.forename: Necdet
authors.initials: N
authors.lastname: Kuyucu
authors.affiliation: j Erciyes University Faculty of Medicine , Department of Social Pediatrics , Kayseri , Turkey.
authors.forename: Meda
authors.initials: M
authors.lastname: Kondolot
authors.affiliation: k Konya Training and Research Hospital, Pediatric Infectious Disease Unit , Konya , Turkey.
authors.forename: Gülnar
authors.initials: G
authors.lastname: Sensoy
authors.affiliation: l Ondokuz Mayıs University Faculty of Medicine , Pediatric Infectious Disease Unit , Samsun , Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Metin
authors.affiliation: m Erzurum Training and Research Hospital, Pediatric Infectious Disease Unit , Erzurum , Turkey.
authors.forename: Soner Sertan
authors.initials: SS
authors.lastname: Kara
authors.affiliation: a Eskisehir Osmangazi University Faculty of Medicine , Department of Pediatrics , Eskisehir , Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Dinleyici
authors.affiliation: a Eskisehir Osmangazi University Faculty of Medicine , Department of Pediatrics , Eskisehir , Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Kılıç
authors.affiliation: b Hacettepe University Faculty of Medicine , Pediatric Infectious Disease Unit , Ankara , Turkey.
authors.forename: Cihangul
authors.initials: C
authors.lastname: Bayhan
authors.affiliation: b Hacettepe University Faculty of Medicine , Pediatric Infectious Disease Unit , Ankara , Turkey.
authors.forename: Venhar
authors.initials: V
authors.lastname: Gurbuz
authors.affiliation: b Hacettepe University Faculty of Medicine , Pediatric Infectious Disease Unit , Ankara , Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Aycan
authors.affiliation: e Ege University Faculty of Medicine, Pediatric Infectious Disease Unit , Izmir , Turkey.
authors.forename: Aygun
authors.initials: A
authors.lastname: Memedova
authors.affiliation: k Konya Training and Research Hospital, Pediatric Infectious Disease Unit , Konya , Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Karli
authors.affiliation: i Mersin University Faculty of Medicine , Pediatric Infectious Disease Unit , Mersin , Turkey.
authors.forename: Gulçin
authors.initials: G
authors.lastname: Bozlu
authors.affiliation: h Uludag University Faculty of Medicine , Pediatric Infectious Disease Unit , Bursa , Turkey.
authors.forename: Solmaz
authors.initials: S
authors.lastname: Celebi
mesh_terms: D000293:Adolescent; D002353:Carrier State / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology*; D002648:Child; D004269:DNA, Bacterial; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D009305:Nasopharynx / Q000382:microbiology; D009345:Neisseria meningitidis / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D065288:Serogroup; D014421:Turkey / Q000453:epidemiology; D014611:Vaccination; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial
keywords: Neisseria meningitidis; Turkey; adolescents; meningococcal vaccines; meningococci; nasopharyngeal colonization