TY - JOUR
T1 - Methods for Identifying Neisseria meningitidis Carriers
T2 - A Multi-Center Study in the African Meningitis Belt
AU - Basta, Nicole E.
AU - Stuart, James M.
AU - Nascimento, Maria C.
AU - Manigart, Olivier
AU - Trotter, Caroline
AU - Hassan-King, Musa
AU - Chandramohan, Daniel
AU - Sow, Samba O.
AU - Berthe, Abdoulaye
AU - Bedru, Ahmed
AU - Tekletsion, Yenenesh K.
AU - Collard, Jean Marc
AU - Jusot, Jean François
AU - Diallo, Aldiouma
AU - Basséne, Hubert
AU - Daugla, Doumagoum M.
AU - Gamougam, Khadidja
AU - Hodgson, Abraham
AU - Forgor, Abudulai A.
AU - Omotara, Babatunji A.
AU - Gadzama, Galadima B.
AU - Watkins, Eleanor R.
AU - Rebbetts, Lisa S.
AU - Diallo, Kanny
AU - Weiss, Noel S.
AU - Halloran, M. Elizabeth
AU - Maiden, Martin C.J.
AU - Greenwood, Brian
PY - 2013/10/23
Y1 - 2013/10/23
N2 - 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.
AB - 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.
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U2 - 10.1371/journal.pone.0078336
DO - 10.1371/journal.pone.0078336
M3 - Article
C2 - 24194921
AN - SCOPUS:84886049157
SN - 1932-6203
VL - 8
JO - PloS one
JF - PloS one
IS - 10
M1 - e78336
ER -