The estimated CCRs are imprecise, as surveillance systems unlikely achieve complete case identification and carriage studies probably underestimate colonisation prevalence. Should the excessive between-study variance be very low or zero, the random-effects model will yield the same results as the fixed-effect model. Meningitis patients do not transmit meningococci substantially more frequently than healthy persons, as disease-specific spreading behaviour such as vomiting occurs after disease onset, when patients are already bound to bed. Published online Feb 6. Measures to prevent this seasonally increased risk of invasive disease given asymptomatic bacterial infection could be developed, in addition to pathogen-specific vaccines. Conclusion Seasonal change in the rate of progression to disease given carriage together with variations in frequency of carriage transmission should be considered in models attempting to capture the epidemiology of meningococcal meningitis and mainly to predict meningitis epidemics in the African meningitis belt.
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Prisma – Blue
Ptisma of the two NmA CCOUs in the Gambian study [ 11 ] was lately excluded from meta-analysis after contact with the main author, because neither requested information nor meteorological data was available to allow classification into the appropriate season and epidemiological context.
Defining an area at risk of epidemic meningitis in Africa.
For further guidance please refer to the introduction and practical guide to pre-clinical meta-analysis. Experimental groups, control group s and number of animals per group. Bull World Health Organ We do not ship this item to your country unless you are registered member. This article has been cited by other articles in PMC.
They likely correspond to long-term strain variations rather than a seasonal phenomenon. S2 Fig Forest plot for meta-analysis of serogroup A meningococcal meningitis case-carrier ratios in vaccinated populations according to epidemiological context in the African meningitis belt.
Estimated Number of rolls. For two studies [ 1124 ], confirmed cases in the hyperendemic context could only be obtained for 4- and 7-month periods, and we approximated monthly incidence as the average incidence. We will assess the effect of our decision to pool all reported scales for histological damage by re-running the analyses using only data from studies using the Jablonski scale.
However, this assumption is unlikely to hold true for data from animal studies, which generally include various species, strains and treatment regimes, for which different true effects are likely to exist.
The authors have declared that no competing interests exist. Our selection criteria included publications in English and French languages. This concerned the number, over specific time periods, of confirmed Nm cases by serogroup, suspected case reporting and age-stratified data. We cannot provide clear evidence on the question whether NmW behaves similar to NmA, as no data for the epidemic context were available. This review was conducted based on an elaborated systematic review and meta-analysis protocol S1 Text.
Appl Microbiol 17 1: Thibautt retrieved records from the initial search of which ten were eligible based on full text screening Fig. Squares show data points in endemic context; triangles show data points in hyperendemic context, and hallow circle show data points in epidemic context. Discussion This is the first study that systematically reviews and synthesizes available serogroup-specific incidence and carriage data of meningococcal meningitis in the meningitis belt.
Received Jun 26; Accepted Dec TIF Click here for additional data file. To test the robustness of our findings when selecting the time point of greatest efficacy we will re-run the analysis with data from the latest possible time point in studies reporting an outcome at multiple time points.
The substantially higher CCR during non-epidemic dry seasons, compared to wet thibakt suggests that seasonal hyperendemicity of NmA meningitis appears related to an increased risk of meningitis given asymptomatic colonisation, but not related to an increase in transmission and colonisation.
Papier peint Géométrique – Papier peint Graphique en ligne (4) – Au fil des Couleurs
Thibajt incidence and CCR increased from endemic to hyperendemic context, although to lesser extent than NmA. The heterogeneity of the hyperendemic estimate was reduced by stratification by vaccination status 14 CCOUs were observed 1 week to 3 years after serogroup A meningococcal polysaccharide vaccine campaigns S2 Fig.
S2 Text Search Strategy. In each phase, 2 observers will independently assess each article. For stratified analyses, a minimum number of 8 studies per subgroup is required. Calculate in metric Calculate in thibauut. If one or more subgroup analyses cannot be performed due to insufficient data, the p-value will be adjusted accordingly.
Lancet Infect Dis 7: Ann Hum Genet Mean daily Relative Humidity MRH in the study area in the two weeks preceding study onset was the main criteria for season assignment. Meningitis patients do not transmit meningococci substantially more frequently than healthy persons, as disease-specific spreading behaviour such as vomiting occurs after disease onset, when patients are already bound to bed.