Acquisition and loss of Neisseria meningitidis carriage in households in Mali

马里家庭脑膜炎奈瑟氏球菌的获得和丧失

• 批准号: 8113844
• 负责人: M Elizabeth Halloran
• 金额: $ 8.39万
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-02 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8113844
• 关键词: Adult; Africa; African; Age; Age Distribution; Antibiotics; Characteristics; Child; Collaborations; Communities; Country; Crowding; Data; Developing Countries; Disease; Disease Outbreaks; Enrollment; Epidemic; Epidemiology; Ethiopia; Europe; Evaluation; Event; Foundations; General Population; Goals; Household; Individual; Institutes; Institution; International; Knowledge; Longitudinal Studies; Mali; Measures; Meningitis; Meningococcal meningitis; Metabolic Clearance Rate; Methods; Molecular; Morbidity - disease rate; Natural History; Neisseria meningitidis; Oropharyngeal; Pilot Projects; Predisposition; Prevalence; Preventive; Protocols documentation; Public Health; Questionnaires; Research; Research Design; Research Personnel; Risk Factors; Sampling; Senegal; Sex Distribution; Smoking; Sore Throat; Source; Stretching; Swab; System; Testing; Time; Travel; Vaccination; Vaccines; Visit; age group; base; design; follow-up; meetings; member; mortality; population based; prevent; programs; research study; transmission process; vaccin protein

DESCRIPTION (provided by applicant): Meningococcal meningitis outbreaks caused by Neisseria meningitidis are responsible for significant morbidity and mortality in the African meningitis belt, a region stretching from Senegal to Ethiopia. Asymptomatic pharyngeal colonization with N. meningitidis, known as carriage, is relatively common compared to invasive disease, and carriers are the primary source of transmission. An affordable conjugate meningococcal serogroup A vaccine has been developed to reduce the burden of meningococcal disease, but it has not yet been introduced into the region. To interrupt transmission and prevent epidemic meningitis, the newly developed vaccine will need to prevent or reduce carriage. Prior to the introduction of this vaccine, studies are needed to further define the epidemiology and basic natural history of carriage in this context. In partnership with the Meningitis Carriage Consortium, an international collaborative effort to characterize the epidemiology of N. meningitidis carriage, and the Centre pour le Diveloppement des Vaccins (CVD-Mali) in Bamako, Mali, the main objective of this study is to investigate rates of acquisition and loss of carriage within households over time, to estimate the average duration of carriage, and to evaluate potential risk factors for carriage. In addition, the aim is to pilot test field and lab protocols for longitudinal follow-up of households in a developing country setting prior to introducing this study design in seven countries of the meningitis belt. To meet these Aims, we propose a household-based longitudinal study of N. meningitidis carriage with 12 months of follow-up. Households will be randomly sampled to identify those households with at least one carrier. Ultimately, 20 households with carriers will be enrolled in and visited monthly. At each visit, an oropharyngeal swab will be collected from all members of the household to determine carrier status and a questionnaire administered to assess potential risk factors. Swabs will be analyzed in the lab using bacteriological and molecular methods to determine the specific serogroup of the strain being carried and the relatedness between strains carried by household members. These data will allow investigators to assess changes in carrier status over time and to define the basic epidemiology of N. meningitidis carriage in the general population in Mali. This study is an important step towards understanding the dynamics of persistence and spread of N. meningitidis. This project will exert a substantive, powerful influence on the research field by laying the foundation for similar longitudinal studies to be carried out in seven countries. This proposed study will also provide baseline data for evaluating the direct and indirect effects of the new meningococcal serogroup A vaccine in Africa. There is a significant need to pilot test field and lab protocols to determine the feasibility and acceptability of longitudinal follow-up of carriers of N. meningitidis in this setting. PUBLIC HEALTH RELEVANCE: This proposed study is relevant to public health because it will further our understanding of the epidemiology and natural history of N. meningitidis carriage, which is one of the primary targets for reducing transmission and preventing outbreaks of invasive meningococcal disease in the African meningitis belt. Our aim is to provide necessary baseline longitudinal data about the average duration of carriage, rates of acquisition and loss, and potential risk factors for carriage within households. Knowledge about these characteristics and the ability to pilot test this design will contribute to the implementation of the same design in seven African countries, which will ultimately assist in the evaluation a new conjugate meningococcal serogroup A vaccine.

描述（由申请人提供）：由奈瑟氏菌脑膜炎引起的脑膜炎球菌暴发疫苗暴发，负责非洲脑膜炎带的显着发病率和死亡率，该地区从塞内加尔延伸到埃塞俄比亚。与侵入性疾病相比，用脑膜炎猪笼草（称为马车）的无症状咽殖定结合是相对常见的，而载体是传播的主要来源。已经开发了一种负担得起的共轭脑膜炎球菌血清群A疫苗来减轻脑膜炎球菌疾病的负担，但尚未引入该地区。为了中断传播和预防流行脑膜炎，新开发的疫苗需要预防或减少运输。在引入该疫苗之前，需要进行研究，以进一步定义在这种情况下运输的流行病学和基本自然历史。与脑膜炎运输联盟合作，这是一项国际合作努力，以表征脑膜炎猪笼草的流行病学，而在马里巴马科的中心倾向于在马里的巴马科，这项研究的主要目的是，这项研究的主要目的是调查在范围内的估计，以估计为估计，以估计为估计，以估计为估计，以估计估计。此外，其目的是在脑膜炎带七个国家引入此研究设计之前，在发展中国家环境中进行纵向测试领域和实验室方案。为了满足这些目标，我们提出了一项基于家庭的纵向研究，并进行了12个月的随访。家庭将被随机取样，以识别那些至少一个携带者的家庭。最终，将每月注册20个带有承运人的家庭。每次访问时，将从家庭的所有成员那里收集口咽拭子，以确定载体状况和调查表，以评估潜在的危险因素。将使用细菌学和分子方法在实验室中分析拭子，以确定所携带的应变的特定血清群以及家庭成员携带的菌株之间的相关性。这些数据将使研究人员能够随着时间的流逝评估载体状态的变化，并定义马里普通人群中脑膜炎脑杆菌的基本流行病学。这项研究是理解脑膜炎链球菌持久性和传播动态的重要一步。该项目将通过为在七个国家 /地区进行类似的纵向研究奠定基础，对研究领域产生实质性强大的影响。这项拟议的研究还将提供基线数据，以评估非洲新脑膜炎球菌A疫苗的直接和间接作用。在这种情况下，重要的是确定N.脑膜炎梭菌载体的纵向随访的可行性和可接受性。 公共卫生相关性：这项拟议的研究与公共卫生有关，因为它将进一步了解脑膜关系的流行病学和自然历史，这是减少传播并防止非洲脑膜炎带中侵袭性脑膜炎球菌疾病爆发的主要目标之一。我们的目的是提供必要的基线纵向数据，涉及到达家庭内部的平均运输持续时间，收购和损失的速度以及家庭内运输的潜在风险因素。有关这些特征和试验测试能力的知识，这种设计将有助于在七个非洲国家实施相同的设计，这最终将有助于评估一种新的共轭脑膜炎球菌血清群A疫苗。