Clonal waves of Neisseria meningitidis colonisation and disease in the African meningitis belt: An eight-year longitudinal study in northern Ghana
2007

Study of Meningococcal Disease in Northern Ghana

Sample size: 300 publication 10 minutes Evidence: moderate

Author Information

Author(s): Julia Leimkugel, Abraham Hodgson, Abudulai Adams Forgor, Valentin Pflüger, Jean-Pierre Dangy, Tom Smith, Mark Achtman, Sébastien Gagneux, Gerd Pluschke

Primary Institution: Swiss Tropical Institute, Basel, Switzerland

Hypothesis

How do levels of Neisseria meningitidis colonization and disease patterns change over time in the African meningitis belt?

Conclusion

The lack of a stable and genetically diverse population of meningococci may contribute to the frequent epidemics of meningococcal disease in the African meningitis belt.

Supporting Evidence

  • The overall meningococcal colonisation rate was 6.0%.
  • Three sequential waves of colonisation with encapsulated meningococci were observed.
  • The colonising meningococcal population was less constant in genotype composition over time compared to industrialised countries.
  • A broad age range of healthy carriers was observed, resembling that of meningitis patients during epidemics.

Takeaway

This study looked at how bacteria that cause meningitis spread in a part of Africa over eight years, showing that the bacteria change a lot and can lead to outbreaks.

Methodology

Throat swabs were taken twice a year from 37 randomly selected compounds in the Kassena-Nankana District, and meningococcal disease was monitored throughout the study.

Potential Biases

The clustering in the sampling procedure may introduce bias in the estimates of standard errors.

Limitations

The study had a relatively small sample size and long sampling intervals, which may have affected the detection of minor clones.

Participant Demographics

The study population was mainly rural, with a broad age range, peaking in teenagers and young adults.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI 0.306–0.393

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.0040101

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication