Pharyngeal carriage of Neisseria species in the African meningitis belt.

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Diallo, Kanny 
Timbine, Youssouf 
Tamboura, Boubou 
Sow, Samba O 

OBJECTIVES: Neisseria meningitidis, together with the non-pathogenic Neisseria species (NPNs), are members of the complex microbiota of the human pharynx. This paper investigates the influence of NPNs on the epidemiology of meningococcal infection. METHODS: Neisseria isolates were collected during 18 surveys conducted in six countries in the African meningitis belt between 2010 and 2012 and characterized at the rplF locus to determine species and at the variable region of the fetA antigen gene. Prevalence and risk factors for carriage were analyzed. RESULTS: A total of 4694 isolates of Neisseria were obtained from 46,034 pharyngeal swabs, a carriage prevalence of 10.2% (95% CI, 9.8-10.5). Five Neisseria species were identified, the most prevalent NPN being Neisseria lactamica. Six hundred and thirty-six combinations of rplF/fetA_VR alleles were identified, each defined as a Neisseria strain type. There was an inverse relationship between carriage of N. meningitidis and of NPNs by age group, gender and season, whereas carriage of both N. meningitidis and NPNs was negatively associated with a recent history of meningococcal vaccination. CONCLUSION: Variations in the prevalence of NPNs by time, place and genetic type may contribute to the particular epidemiology of meningococcal disease in the African meningitis belt.

African meningitis belt, Non-meningococcal Neisseria, Pharyngeal carriage, Adolescent, Adult, Africa, Bacterial Outer Membrane Proteins, Carrier State, Child, Child, Preschool, Female, Genetic Variation, Humans, Infant, Male, Meningitis, Meningococcal, Meningococcal Infections, Neisseria, Neisseria meningitidis, Pharynx, Prevalence, Risk Factors, Young Adult
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J Infect
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Elsevier BV
Bill & Melinda Gates Foundation (via London School of Hygiene & Tropical Medicine) (ITDCVT64: UCAM)
Wellcome Trust (100891/Z/13/Z)
MenAfriCar was funded by the Wellcome Trust (086546/Z/08/Z) and the Bill and Melinda Gates Foundation (51251). Kanny Diallo holds a Wellcome Trust Training Fellowship in Public Health and Tropical Medicine.