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            <idno type="stamp" n="METIS-EHESP" corresp="EHESP">Département Méthodes quantitatives en santé publique</idno>
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                <title xml:lang="en">Study of a Localized Meningococcal Meningitis Epidemic in Burkina Faso: Incidence, Carriage, and Immunity</title>
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                  <persName>
                    <forename type="first">Judith E.</forename>
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                  <idno type="halauthorid">2091587-0</idno>
                  <affiliation ref="#struct-351663"/>
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                    <forename type="first">Sita S.</forename>
                    <surname>Kroman</surname>
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                  <idno type="halauthorid">796371-0</idno>
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                  <idno type="halauthorid">1803039-0</idno>
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                    <forename type="first">Lassana</forename>
                    <surname>Sangaré</surname>
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                  <idno type="halauthorid">2091589-0</idno>
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                <author role="aut">
                  <persName>
                    <forename type="first">Raymond</forename>
                    <surname>Borrow</surname>
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                  <idno type="halauthorid">529917-0</idno>
                </author>
                <author role="aut">
                  <persName>
                    <forename type="first">Bradford D.</forename>
                    <surname>Gessner</surname>
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                <idno type="eissn">1537-6613</idno>
                <title level="j">Journal of Infectious Diseases</title>
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                  <publisher>Oxford University Press</publisher>
                  <biblScope unit="volume">204</biblScope>
                  <biblScope unit="issue">11</biblScope>
                  <biblScope unit="pp">1787-1795</biblScope>
                  <date type="datePub">2011-12-01</date>
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                <term xml:lang="en">Omega-n-methylarginine</term>
                <term xml:lang="en">Polymerase chain reaction</term>
                <term xml:lang="en">Meningitis</term>
                <term xml:lang="en">Burkina faso</term>
                <term xml:lang="en">Dsease transmission</term>
                <term xml:lang="en">Immunity</term>
                <term xml:lang="en">Meningococcal meningitis</term>
                <term xml:lang="en">Smoke</term>
                <term xml:lang="en">Polysaccharides</term>
                <term xml:lang="en">Serogroup</term>
                <term xml:lang="en">Seroprevalence</term>
                <term xml:lang="en">Surveillance</term>
                <term xml:lang="en">Epidemics</term>
                <term xml:lang="en">Vaccines</term>
                <term xml:lang="en">Vaccination</term>
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              <p>Background. To better understand localized meningococcal meningitis epidemics, we evaluated a serogroup A (NmA) epidemic in Burkina Faso by surveillance, carriage, and seroprevalence studies.Methods. During March–April 2006, cerebrospinal fluid samples from patients suspected to have meningitis in 3 epidemic villages were analyzed by culture or polymerase chain reaction. We assessed meningococcal carriage and serogroup-specific serum bactericidal antibody titers with baby rabbit complement (rSBA) in a representative population sample (N = 624; age range, 1–39 years). A serogroup A/C polysaccharide vaccine campaign occurred in parallel.Results. Cumulative incidence of Nm meningitis was 0.45% and varied among villages (0.08%–0.91%). NmA carriage prevalence was 16% without variation by vaccination status. NmA carriage and anti-NmA seroprevalence varied by village and incidence. In the 2 villages with highest incidence and seroprevalence, presence of rSBA titers ≥8 was associated with NmA carriage (odds ratio [OR], 9.33 [95% confidence interval {CI}, 1.90–45.91]) and vaccination ≤4 days earlier (OR, 0.10 [95% CI, .03–.32]). Visibly purulent or Nm meningitis was significantly associated with recent flulike symptoms and exposure to kitchen smoke (risk ratios &gt;15).Conclusions. A surge of NmA carriage may be involved in the development of meningococcal epidemics and rapidly increase anti-NmA seroprevalence. Flulike infection and kitchen smoke may contribute to the strength of epidemics.</p>
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