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OBJECTIVE: To investigate potential risk factors for acquisition in seven countries of the meningitis belt. METHODS: Households were followed up every 2 weeks for 2 months, then monthly for a further 4 months. Pharyngeal swabs were collected from all available household members at each visit and questionnaires completed. Risks of acquisition over the whole study period and for each visit were analysed by a series of logistic regressions. RESULTS: Over the course of the study, acquisition was higher in: (i) 5-to 14-year olds, as compared with those 30 years or older (OR 3.6, 95% CI 1.4-9.9); (ii) smokers (OR 3.6, 95% CI 0.98-13); and (iii) those exposed to wood smoke at home (OR 2.6 95% CI 1.3-5.6). The risk of acquisition from one visit to the next was higher in those reporting a sore throat during the dry season (OR 3.7, 95% CI 2.0-6.7) and lower in those reporting antibiotic use (OR 0.17, 95% CI 0.03-0.56). CONCLUSIONS: Acquisition of meningococcal carriage peaked in school age children. Recent symptoms of sore throat during the dry season, but not during the rainy season, were associated with a higher risk of acquisition. Upper respiratory tract infections may be an important driver of epidemics in the meningitis belt.

Original publication




Journal article


Trop Med Int Health

Publication Date





392 - 400


Neisseria meningitidis , Africa, Afrique, Neisseria meningitidis, acquisition, facteurs de risque, risk factors, Adolescent, Adult, Africa South of the Sahara, Aged, Anti-Bacterial Agents, Carrier State, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Logistic Models, Male, Meningitis, Meningococcal, Middle Aged, Neisseria meningitidis, Serogroup A, Pharyngitis, Respiratory Tract Infections, Risk Factors, Seasons, Smoke, Smoking, Young Adult