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Risk factors for acquisition of meningococcal carriage in the African meningitis belt
Author(s) -
Cooper Laura V.,
Robson Anna,
Trotter Caroline L.,
Aseffa Abraham,
Collard JeanMarc,
Daugla Doumagoum Moto,
Diallo Aldiouma,
Hodgson Abraham,
Jusot JeanFrançois,
Omotara Babatunji,
Sow Samba,
HassanKing Musa,
Manigart Olivier,
Nascimento Maria,
Woukeu Arouna,
Chandramohan Daniel,
Borrow Ray,
Maiden Martin C. J.,
Greenwood Brian,
Stuart James M.
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13203
Subject(s) - medicine , sore throat , carriage , meningitis , respiratory tract infections , pediatrics , meningococcal meningitis , logistic regression , throat , epidemiology , surgery , neisseria meningitidis , respiratory system , pathology , biology , bacteria , genetics
Objective To investigate potential risk factors for acquisition in seven countries of the meningitis belt. Methods Households were followed up every 2 weeks for 2 months, then monthly for a further 4 months. Pharyngeal swabs were collected from all available household members at each visit and questionnaires completed. Risks of acquisition over the whole study period and for each visit were analysed by a series of logistic regressions. Results Over the course of the study, acquisition was higher in: (i) 5‐to 14‐year olds, as compared with those 30 years or older ( OR 3.6, 95% CI 1.4–9.9); (ii) smokers ( OR 3.6, 95% CI 0.98–13); and (iii) those exposed to wood smoke at home ( OR 2.6 95% CI 1.3–5.6). The risk of acquisition from one visit to the next was higher in those reporting a sore throat during the dry season ( OR 3.7, 95% CI 2.0–6.7) and lower in those reporting antibiotic use ( OR 0.17, 95% CI 0.03–0.56). Conclusions Acquisition of meningococcal carriage peaked in school age children. Recent symptoms of sore throat during the dry season, but not during the rainy season, were associated with a higher risk of acquisition. Upper respiratory tract infections may be an important driver of epidemics in the meningitis belt.