Table 2.
Summary of studies from low- and middle-income countries of the Americas
| Reference | Population | Settinga | Date | Epidemiology of carriage isolates, % | Risk factors |
|---|---|---|---|---|---|
| Brazil | |||||
| Nunes et al. [33] | Students aged 11–19 years attending 134 municipal or state public schools in Salvador (n = 1200) | Vaccinated | Sep–Dec 2014 | Overall: 4.9b |
Significant risks of carriage 1 household room for sleeping: PR 2.02 (P = 0.05) Only mother/siblings smoked: PR 2.48 (P = 0.01) Attend pubs/parties ≥ 5 ×/month: PR 2.61 (P = 0.02) |
| Moura et al. [34] | Students aged 11–19 years attending public schools in Salvador (n = 1200) | Vaccinated | Sep–Dec 2014 |
Overall: NAc By serogroupd MenA: 0 MenB: 11.9 MenC: 3.4 MenE: 6.8 MenW: 3.4 MenX: 0 MenY: 8.5 MenZ: 5.1 NG: 61.0 Capsule null: 50.0 |
– |
| Cassio de Moraes et al. [35] | Students aged 11–19 years attending 73 schools in Campinas (n = 1208) | Vaccinated and unvaccinated | May–Jul 2012 |
Overall: 9.93b By serogroupb MenB: 0.99 MenC: 1.32 MenE: 0.74 MenW: 0.25 MenY: 0.49 MenZ: 0.08 NG: 6.04 |
Carriage by age group, %b 11–13 years (n = 487): 9.2 14–16 years (n = 450): 8.9 17–19 years (n = 271): 12.9 Significant independent risk factor for carriage Parental education level: OR 2.14 (P = 0.022) |
| Weckx et al. [36] | Subjects aged 1–24 years from 6 basic healthcare units and 3 schools in São Paulo (n = 967) | Vaccinated and unvaccinated | Oct 2011–May 2012 |
Overall: 9.0b By serogroupd MenA: 0 MenB: 12.6 MenC: 18.4 NG: 60.9 |
Carriage by age group, %d MenB most common in 20–24 years (n = 13): 23.1 MenC most common in 15–19 years (n = 16): 37.5 MenY most common in 5–9 years (n = 18): 11.1 |
| Coch Gioia et al. [37] | Subjects aged 20–60 years from Miguel Riet Correia University Hospital in Rio Grande do Sul State (n = 200) | Vaccinated | 2011 | Overall: 9b |
Significant risks of carriage, carriers vs. non-carriers Male sex: 55.5% vs. 27.4% (P = 0.013) Younger age: 26.5 vs. 33.3 years (P = 0.02) Bar attendance: 88.9% vs. 53.8% (P = 0.004) Bar attendance 1–2 ×/month: 72.2% vs. 42.8% (P = 0.01) Mean number of people in the same house: 1.94 vs. 2.66 (P = 0.04) |
| Safadi et al. [38] | Subjects working in 2 oil refineries in São Paulo State (n = 483) | Post-outbreak; post-vaccination | Mar 29–Jun 30, 2010 |
Overall: 21.5b By serogroupd MenB: 16.1 MenC: 48.2 MenE: 14.3 MenY: 12.5 MenW: 8.9 NG: 46.1 |
Significant risk of carriage Not completing secondary education: 32.9% among carriers vs. 19.2% among noncarriers (P = 0.01) |
| Barroso [39] | Patients with clinical diagnosis of meningococcal disease admitted to Reference Centre, São Sebastião State Institute in Rio de Janeiro (n = 63) | Hospitalized patients | – |
Carriage rate at admission: 62b Carriage rate on discharge: 4b Carriage rate in close contacts after 10 days of chemoprophylaxis: 0b |
– |
| Chile | |||||
| Rubilar et al. [40] | Subjects aged 9–19 y (n = 184 carriage; n = 119 invasive) | – | Apr–Jun 2013 |
Overall: NA By serogroupe MenB: carriers, 40; patients, 32 MenC: carriers, 18; patients, < 2 MenW: carriers, 5; patients, 66 NG: carriers, 26; patients, 0 |
Carriage by age group, %d 9–10 years: 7.6 11–13 years: 26.6 14–17 years: 49.0 18–19 years: 16.8 |
| Diaz et al. [42] | Subjects aged 10–19 years from 19 hospitals, 15 university campuses, and 56 schools in the 3 most populated regions (Metroplitana, Valparaíso, Biobio; n = 4217) | Post-increase in MenW cases; unvaccinated | Apr 15–Jul 6, 2013 |
Overall: 6.5 (95% CI: 5.7, 7.3)b By serogroupb MenB: 1.7 MenC: 0.8 MenW: 0.2 MenY: 0.6 MenZ: 0.05 NT: 3.0 |
Significant risks of carriage, OR Age: 1.077 (P = 0.002) Number of children in household: 1.182 (P = 0.02) Exposure to tobacco in the household in children aged < 14 years: 0.232 (P = 0.013) Number of smoking cohabitants in children aged < 14 years: 1.784 (P = 0.014) Number of children living in household for children aged < 14 years: 1.245 (P = 0.044) Exposure to tobacco in the household for children aged ≥ 14 years: 1.47 (P = 0.029) Female sex for children aged ≥ 14 years: 0.663 (P = 0.014) |
| Rodriguez et al. [41] | University students aged 18–24 years in Santiago (n = 500) | – | Oct 2012 |
Overall: 4b By serogroupd MenB: 20 MenW: 15 Noncapsulated: 65 |
Significant risks of carriage Shared room: 25% of carriers vs. 15% of noncarriers (P = 0.02) Pub attendance: 85% of carriers vs. 63% of noncarriers (P = 0.05) |
| Colombia | |||||
| Moreno et al. [43] | Students aged 15–21 years attending 12 secondary and 7 universities in Bogotá (n = 1459) | – | Aug–Oct 2012 | Overall: 6.85b |
Carriage by age group, %d Highest in 21 years: 7.0 Lowest in 18 years: 2.5 Significant risk of carriage Engaging in oral sex: OR 1.70 (P = 0.030) |
| Cuba | |||||
| Climent et al. [32] | Students aged 0–12 years and 14–22 years attending kindergarten, primary school, high school, military school, or university (n = 167 disease; n = 253 carriers) | Unvaccinated and vaccinated | 1983–2005 |
Overall: NA By serogroupd MenB: 57.5 MenC: 0 MenW: 1.0 MenZ: 0.5 NG: 40.9 |
– |
| Martinez Motas et al. [47] | Isolates collected from healthy carriers [32] during MenB epidemic and post-epidemic periods | Epidemic and post-epidemic; unvaccinated and vaccinated [32] |
1982–1992 (epidemic period) 1993–2002 (post-epidemic period) |
Overall: NA By serogroupd Epidemic period: MenB: 67.6 MenW: 0 MenY: 0 MenZ: 0 NG: 32.4 Post-epidemic period: MenB: 17.3 MenW: 2.2 MenY: 0.4 MenZ: 0.4 NG: 79.7 |
– |
| Mexico | |||||
| Espinosa de los Monteros et al. [44] | Subjects aged between 15–19 years living in social rehabilitation centers or attending universities and children aged < 5 years attending daycare centers in Mexico City (n = 2310) | – | Sep 2004–Apr 2005 |
Overall: 1.6b Daycare center attendees (n = 736): 1.9b Social rehabilitation living (n = 774): 2.9b University attendees (n = 800): 0b By serogroup:d MenC: 24.3 MenY: 29.7 |
– |
| Paraguay | |||||
| Chamorro et al. [45] | Subjects aged 3–21 years from 4 health services and 22 schools in Asuncion and the metropolitan area (n = 2011) | Vaccinated and unvaccinated | Mar 2011–Dec 2012 |
Overall: 2.1b By serogroupd MenB: 26.0 MenC: 9.0 MenY: 9.0 Men C: 6.0 |
– |
Men meningococcal serogroup, NA not available, NG nongroupable, NT nontypeable, OR odds ratio, PR prevalence ratio
aSpecific details regarding setting are described in detail in the “Results”
bPercent of subjects/samples
cReported in Nunes et al. [33]
dPercent of carriers
ePercent of carriers and patients, respectively