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Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt

Nicole Basta 1, 2, 3, * James Stuart 4 Maria Nascimento 4 Olivier Manigart 4 Caroline Trotter 5 Musa Hassan-King 4 Daniel Chandramohan 4 Samba Sow 6 Abdoulaye Berthe 6 Ahmed Bedru 7 Yenenesh Tekletsion 7, 8 Jean-Marc Collard 9 Jean-François Jusot 9 Aldiouma Diallo 10 Hubert Basséne 10 Doumagoum Daugla 11 Khadidja Gamougam 11 Abraham Hodgson 12 Abudulai Forgor 13 Babatunji Omotara 14 Galadima Gadzama 14 Eleanor Watkins 8 Lisa Rebbetts 8 Kanny Diallo 6, 8 Noel Weiss 3, 15 M. Elizabeth Halloran 3, 15 Martin Maiden 8 Brian Greenwood 4
* Corresponding author
1 Princeton University
2 NIH - National Institutes of Health [Bethesda]
3 FHCRC - Fred Hutchinson Cancer Research Center [Seattle]
4 LSHTM - London School of Hygiene and Tropical Medicine
5 CAM - University of Cambridge [UK]
6 Centre pour le Développement des Vaccins [Mali]
7 AHRI - Armauer Hansen Research Institute
8 University of Oxford [Oxford]
9 CERMES - Centre de Recherche Médicale et Sanitaire (Niamey, Niger)
10 IRD [Sénégal] - Institut de recherche pour le développement
11 CSSI - Centre de Support en Santé Internationale [N'Djamena, Tchad]
12 Ghana Health Service [Accra, Ghana]
13 War Memorial Hospital [Navrongo, Ghana]
14 University of Maiduguri
15 University of Washington [Seattle]
Abstract : Objective Detection of meningococcal carriers is key to understanding the epidemiology of Neisseria meningitidis, yet no gold standard has been established. Here, we directly compare two methods for collecting pharyngeal swabs to identify meningococcal carriers. Methods We conducted cross-sectional surveys of schoolchildren at multiple sites in Africa to compare swabbing the posterior pharynx behind the uvula (U) to swabbing the posterior pharynx behind the uvula plus one tonsil (T). Swabs were cultured immediately and analyzed using molecular methods. Results One thousand and six paired swab samples collected from schoolchildren in four countries were analyzed. Prevalence of meningococcal carriage was 6.9% (95% CI: 5.4-8.6%) based on the results from both swabs, but the observed prevalence was lower based on one swab type alone. Prevalence based on the T swab or the U swab alone was similar (5.2% (95% CI: 3.8-6.7%) versus 4.9% (95% CI: 3.6-6.4%) respectively (p=0.6)). The concordance between the two methods was 96.3% and the kappa was 0.61 (95% CI: 0.50-0.73), indicating good agreement. Conclusions These two commonly used methods for collecting pharyngeal swabs provide consistent estimates of the prevalence of carriage, but both methods misclassified carriers to some degree, leading to underestimates of the prevalence.
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https://hal-riip.archives-ouvertes.fr/pasteur-03238545
Contributor : Jean-Marc Collard <>
Submitted on : Thursday, May 27, 2021 - 10:38:49 AM
Last modification on : Saturday, June 26, 2021 - 3:34:58 AM

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Nicole Basta, James Stuart, Maria Nascimento, Olivier Manigart, Caroline Trotter, et al.. Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt. PLoS ONE, Public Library of Science, 2013, 8 (10), pp.e78336. ⟨10.1371/journal.pone.0078336⟩. ⟨pasteur-03238545⟩

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