Work

Dynamic characteristics of Neisseria meningitidis carriage among new students in boarding martial arts schools: a longitudinal follow-up study

Year: 2026

Type: article

Abstract: Objective: (Nm) carriage, identify factors influencing Nm acquisition and clearance, and provide empirical evidence for understanding the epidemiological mechanisms of Nm carriage and for developing targeted prevention strategies. Methods: A prospective cohort of 60 new entrants was established at a boarding martial arts school in Dengfeng City from February to December 2025. Oropharyngeal swabs were collected at regular intervals and subjected to laboratory testing. A hidden Markov model (HMM) was applied to estimate acquisition and clearance rates of Nm, and proportional hazards models were used to assess the effects of covariates on these rates. Results: A total of 13 follow-up visits and samplings were completed. The Nm carriage prevalence ranged from 30.00 to 93.75%, showing an overall upward trend, with serogroups B and X being predominant. During the observation period, 52.54% (31/59) of positive carriers exhibited ≥2 carriage episodes, and 35.59% (21/59) carried ≥2 serogroups over time. The mean carriage duration was estimated at 7.38 months (95% CI: 4.18-13.01). For Nm acquisition, individuals aged ≥15 years had a higher acquisition rate than those aged <15 years (HR = 2.01, 95% CI: 0.99-4.08), and those with a smoking history showed a higher acquisition rate than non-smokers (HR = 1.48, 95% CI: 0.76-2.91), although the latter difference was not statistically significant. For Nm clearance, age ≥15 years (HR = 4.40, 95% CI: 1.49-13.00) and fever in the past week (HR = 4.16, 95% CI: 1.36-12.75) were significantly associated with higher clearance rates. Smoking history (HR = 3.39, 95% CI: 0.92-12.53) and antibiotic use (HR = 2.58, 95% CI: 0.74-9.05) also suggested potential associations with increased clearance, but these did not reach statistical significance. Conclusion: New entrants in this boarding martial arts school exhibited a high risk of Nm carriage, with prolonged average carriage duration and frequent serogroup switching during carriage episodes. Age ≥15 years and recent fever were significantly associated with enhanced Nm clearance. These findings underscore the need for strengthened health surveillance and behavioral interventions to reduce the risk of persistent carriage and onward transmission in such congregate settings.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1941998