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A Seroepidemiological Study of Serogroup A Meningococcal Infection in the African Meningitis Belt.


Type

Article

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Authors

Manigart, Olivier 
Findlow, Helen 
Assefa, Abraham 
Mihret, Wude 

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.

Description

Keywords

Adolescent, Adult, Africa, Aged, Antibodies, Bacterial, Carrier State, Child, Child, Preschool, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Epidemics, Female, Humans, Immunoglobulin G, Immunologic Memory, Infant, Male, Meningitis, Meningococcal, Meningococcal Vaccines, Middle Aged, Neisseria meningitidis, Seroepidemiologic Studies, Serogroup, Vaccination

Journal Title

PLoS One

Conference Name

Journal ISSN

1932-6203
1932-6203

Volume Title

11

Publisher

Public Library of Science (PLoS)
Sponsorship
Bill & Melinda Gates Foundation (via London School of Hygiene & Tropical Medicine) (ITDCVT64: UCAM)
Wellcome Trust (100891/Z/13/Z)
The work described in this paper was supported by grants to the MenAfriCar Consortium from the Wellcome Trust (grant no. 086546/Z/08/Z and the Bill and Melinda Gates Foundation (grant no 51251).