Methods for Identifying Neisseria meningitidis Carriers: A Multi-Center Study in the African Meningitis Belt
Year: 2013
Type: article
Study design: Observational Study
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.
Source: PLoS ONE
Authors: Nicole E. Basta, James M. Stuart, Maria C. Nascimento, Olivier Manigart, Caroline Trotter, Musa Hassan-King, Daniel Chandramohan, Samba O. Sow, Abdoulaye Berthe, Ahmed Bedru, Yenenesh K. Tekletsion, Jean-Marc Collard, Jean-François Jusot, Aldiouma Diallo, Hubert Basséne, Doumagoum M. Daugla, Khadidja Gamougam, Abraham Hodgson, Abudulai A. Forgor, Babatunji A. Omotara, Galadima B. Gadzama, Eleanor R. Watkins, Lisa S. Rebbetts, Kanny Diallo, Noel S. Weiss, M. Elizabeth Halloran, Martin C. J. Maiden, Brian Greenwood
Institutions: National Institutes of Health, Princeton University, Fred Hutch Cancer Center, Fogarty International Center, London School of Hygiene & Tropical Medicine, University of Cambridge, Centre Pour le Développement des Vaccins-Mali, Armauer Hansen Research Institute, University of Oxford, Centre de Recherche Médicale et Sanitaire, Institut de Recherche pour le Développement, Centre de Support en Santé Internationale, Ghana Health Service, University of Maiduguri, University of Washington
Language: English
Subfield: Microbiology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W2131760675