MenAfriCar

The African meningococcal carriage consortium (MenAfriCar), supported by both the Bill and Melinda Gates Foundation and the Wellcome Trust, was established in 2009 and has investigated patterns of carriage of meningococci in seven countries of the African meningitis belt. Age stratified, cross-sectional surveys were conducted in seven countries of the African meningitis belt on three occasions over a period of two years; 48,490 individuals provided a pharyngeal swab and 1,687 meningococci were isolated. These surveys showed that: • the overall prevalence of meningococcal carriage in the African meningitis belt identified during the crosssectional surveys (3.4% [95% CI 3.2% - 3.6%]) was less than that generally found in industrialised countries; • the prevalence of carriage varies markedly between countries of the African meningitis belt at the same point of time and over relatively short periods of time in the same country; • a high proportion of carriage isolates were capsule null and therefore unable to elaborate a polysaccharide capsule; • MenAfriVac is highly effective at preventing carriage of serogroup A meningococci. An important further component of MenAfriCar's activities was a study of the pattern of carriage of meningococci within and outside households. This study showed a high rate of transmission within households, 21% of subjects who lived in a household with an index carrier acquired a meningococcus during the follow-up period compared with 9% in control households. Older children were the group most frequently identified as new carriers in the control households. The mean duration of carriage was 3.4 months [95% CI 2.7 – 4.3 months] and very few long-term carriers were found. page 1 [A4] Please state all collaborating PIs (and name of Institution) [A6] Is this a joint project with another Sanger PI, if so state name(s) [A7] Please provide text (abstract) which will accompany data for this study in the ENA/EGA. [A8] Does this project use samples? [A9] Please choose which types of sample you will be using [A11] Please select the anticipated date (month/year) samples will be available in-house (if known). If samples are already in-house, type 'in-house' here. Please note that for sequencing, genotyping and microarrays this is essential for scheduling the work. [A12] Please select the anticipated project start date (month/year). [A13] Please state the project duration (months). [A14] Please read WTSI's Data Sharing Policy and Guidelines, then explain your data sharing plans for the project [A15] Are the data sharing plans of this project compliant with the Institute's Guidelines? A unique collection of meningococci, totalling 1687 isolates from the cross-sectional studies and 991 from the household studies (in total 2678 less 79 from Mali that have already been sequenced, giving 2599) now exists. These isolates have been shipped to PHE's Meningococcal Reference Unit (MRU) in Manchester where they are safely stored. The aim of the study is to characterise and describe the MenAfriCar collection using whole genome sequencing (WGS). Specific research objectives will include, but are not limited to: • defining transmission events within households and examining changes in strains carried by the same individual over time; • geo-referencing the carriage isolates and describing the geographic and temporal differences; • comparing carriage isolates from Africa with a contemporary UK carriage collection.