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Article

WHO Collaborating Centre for Reference and Research on Meningococci

Published Updated

The World Health Organization (WHO) is committed to eliminating meningococcal disease as a public health problem.

The World Health Organization (WHO) is committed to eliminating meningococcal disease as a public health problem.

Meningococcal disease constitutes an enormous public health burden, especially in sub-Saharan Africa where large-scale epidemics still occur. 

The Norwegian Institute of Public Health (NIPH), which has been an appointed WHO Collaborating Centre for Reference and Research on Meningococci since 1991, contributes to the task of eliminating meningococcal disease worldwide.

Meningococcal disease is caused by the bacterium Neisseria meningitidis (the meningococcus). There are two predominant clinical forms of meningococcal disease, septicaemia (or blood stream infection) and meningitis which is a serious infection affecting the brain membranes. The disease can lead to severe disability, including hearing loss, mental retardation and epilepsy, and case-fatality rates are around 10 per cent, even with optimal patient care. The meningococcus is the only bacterium which causes large meningitis epidemics. In the so-called meningitis belt of sub-Saharan Africa, a region encompassing all or part of 26 countries from Senegal in the West to Ethiopia in the East, large epidemics of meningococcal meningitis recur every few years.

The disease is transmitted by air-borne droplets from people who have the bacterium in their throat, but are without symptoms (asymptomatic carriers). Twelve groups of the Neisseria meningitidis have been identified, five of which (A, B, C, W, and X) can cause epidemics. The large epidemics in the meningitis belt were mainly caused by strains of serogroup A, until an affordable monovalent protein-conjugate polysaccharide vaccine against group A meningococci (MenAfriVac®) was introduced in mass vaccination campaigns, starting in 2010. The vaccine is now given to small children in most countries in the meningitis belt through the Expanded Program on Immunization. Following this extremely successful vaccine implementation, serogroup A meningococcal disease is now basically absent from the meningitis belt. However, serogroups C, W and X are circulating in the region and, while giving raise to smaller epidemics, are still a significant public health problem. Multivalent protein-conjugate polysaccharide vaccines are being developed, and a pentavalent (A, C, W, Y and X) should soon be WHO prequalified.

In 2017, representatives from governments, global health organizations, public health bodies, academia, private sector, and civil societies called for a global vision of a world free of meningitis. WHO took up the call to action and, with global partners, has developed a roadmap to defeat meningitis by 2030. The road map focuses on the four major meningitis-causing bacterial pathogens, one of which is N. meningitidis. The visionary goals of the road map are to: (i) eliminate epidemics of bacterial meningitis; (ii) reduce cases of vaccine-preventable bacterial meningitis by 50 % and deaths by 70 %; and (iii) reduce disability and improve quality of life after meningitis of any cause. To achieve these goals, the road map has key activities across five pillars: prevention and epidemic control; diagnosis and treatment; disease surveillance; support and care for people affected by meningitis, and advocacy and engagement.

The Norwegian Institute of Public Health was designated as a WHO Collaborating Centre 30 years ago due to the expertise and engagement of its employees in the study of meningococcal meningitis globally. Through the years the Centre has supported WHO in contributing to diagnostic and outbreak detection in other countries, in monitoring worldwide spread of virulent strains using molecular methods, and with capacity building, particularly in Africa. The Centre’s director is currently engaged as an individual expert in the Technical Task Force of the road map for defeating meningitis by 2030.

Responsibilities of the WHO Collaborating Centre

Analysis

  • Collection of all systemic meningococci isolates from Norway’s medical microbiological laboratories.
  • Reference studies of meningococcal strains from Norway and abroad (serogroup determination, resistance characterization and whole genome sequencing).
  • Performance of meningococcal carriage studies around cases/epidemics and in particular population groups. 
  • Monitoring of N. meningitidis strains from various geographical areas and epidemiological situations using whole genome sequencing and various schemes for characterization. Collection & analysis of information are disseminated through WHO-HQ & WHO-RO to the interested countries by an annual report and, if needed, by other means.
  • Genetic studies of culture-negative cerebrospinal fluids and sera from meningitis patients.

Research

  • Monitoring variations and extent of virulence properties and antimicrobial resistance among meningococci.
  • Studies of the population genetics and evolution of Neisseria species. 
  • Research related to meningococcal vaccines: characterization of meningococcal antigens and study antibody response after vaccination and disease.

Services

  • Maintain a meningococcal strain bank. 
  • Contribute to diagnostic and outbreak detection in other countries (particularly in Africa). 
  • Support development of new rapid diagnostic tests.
  • Support implementation of new genetic-based typing methods in other countries. 
  • Help to establish quality control of laboratory methods. 
  • Provide reference strains, clinical isolates and other material (e.g. DNA) upon request for eligible parties like: the National reference laboratories in the allocated countries; European and North American laboratories that are part of the Global Laboratory Network on Meningococcal Diseases. 
  • Production of material for transport (e.g. Trans-Isolate medium) of clinical samples and isolates within and between countries. 
  • Open to requests to strengthen diagnostic functions in other countries on site.

Reporting 

  • Report results to international collaboration partners. 
  • Responsibility for presenting, together with the other WHO Collaborating Centres for Reference and Research on Meningococci, an annual joint analysis of the meningococcal situation with conclusions and possibilities/problems for the future.

About WHO Collaborating Centres

The WHO Collaborating Centres are institutions, such as research institutes, parts of universities or academies, which are designated by the WHO’s Director-General to carry out activities in support of the Organization's programmes. Currently there are over 800 WHO collaborating centres in over 80 Member States working with WHO on areas, such as nursing, occupational health, communicable diseases, nutrition, mental health, chronic diseases and health technologies. (Source: WHO).

Contact

Prof. - Director of the Centre

Division for Infection Control
Norwegian Institute of Public Health
P.O. Box 222 Skøyen 
0213 Oslo, Norway

Tel: (+47) 93863188

For a list of publications from the Centre, see References below.

References

  1. Brynildsrud, O. B., S. V. Watle, K. Alfsnes, and D. A. Caugant. Invasive meningococcal disease in Norway in the two decades prior to the covid-19 pandemic. Intern. J. Infect. Dis. Manuscript submitted.
  2. Næss, L. M., I. Skogsrud, D. A. Caugant, A. Kassu, A. Aseffa, and B. Børud. Genetic, functional, and immunogenic analyses of the O-linked protein glycosylation system in Neisseria meningitidis serogroup A ST-7 isolates. Bact. Manuscript submitted.
  3. Asturias, E. J., X. Bai, J. A. Bettinger, R. Borrow, D. N. Castillo, D. A. Caugant, G. C. Chacon, E. C. Dinleyici, G. E. Aviles, L. Garcia, L. Glennie, L. H. Harrison, R. L. Howie, M. Itsko, J. Lucidarme, J. E. O. Marin, H. Marjuki, L. A. McNamara, M. M. Mustapha, J. L. Robinson, B. Romeu, M. Sadarangani, X. Sáez-Llorens, M. A. P. Sáfadi, D. S. Stephens, J. M. Stuart, M.-K.Taha, R. S. W. Tsang, J. Vazquez, P. De Wals. 2022. Meningococcal disease in North America: Updates from the Global Meningococcal Initiative. Infect. 85: 611-622.
  4. Alderson, M. R., P. D. Arkwright, X. Bai, S. Black, R. Borrow, D. A. Caugant, E. C. Dinleyici, L. H. Harrison, J. Lucidarme, L. A. McNamara, S. Meiring, M. A. P. Sáfadi, Z. Shao, D. S. Stephens, M.-K. Taha, J. Vazquez, B. Zhu, and GMI Collaborators. 2022. Surveillance and control of meningococcal disease in the COVID-19 era: A Global Meningococcal Initiative review. Infect. 84: 289-296.
  5. Sharma, S., J. Acharya, D. A. Caugant, S. Aryal, M. Raj Banjara, P. Ghimire and A. Singh. 2021. Meningococcal carriage among household contacts of patients with invasive meningococcal disease in Kathmandu, Nepal: A longitudinal study. Pathogens 10: 781.
  6. MacAlasdair, N., M. Pesonen, O. Brynildsrud, V. Eldholm, P. A. Kristiansen, J. Corander, D. A. Caugant, and S. D. Bentley. 2021. The effect of recombination on the evolution of a population of Neisseria meningitidis. Genome Res. 31: 1258-1268.
  7. Sharma, S., J. Acharya, D. A. Caugant, M. Raj Banjara, P. Ghimire and A. Singh. 2021. Detection of Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae in culture negative cerebrospinal fluid samples by multiplex polymerase chain reaction. Dis. Rep. 13: 173-180.
  8. Watle, S. V., L. M. Næss, G. Tunheim, D. A. Caugant, and T. Wisløff. 2021. Cost-effectiveness of meningococcal vaccination of Norwegian teenagers with a quadrivalent ACWY conjugate vaccine. Vacc. Immunother. 17: 2777-2787.
  9. Diallo, K., V. F. Feteh, L. Ibe, M. Antonio, D. A. Caugant, M. du Plessis, A. E. Deghmane, I. M. Feavers, K. Fernandez, L. M. Fox, C. M. C.Rodrigues, O. Ronveaux, M. K. Taha, X. Wang, A. B. Brueggemann, M. C. J. Maiden, and O. B. Harrison. 2021. Molecular diagnostic assays for the detection of common bacterial meningitis pathogens: A narrative review. EBio Medicine. 65: 103274.
  10. Feagins, A. R., O. Ronveaux, M.-K. Taha, A. Caugant, V. Smith, K. Fernandez, L. Glennie, L. M. Fox, and X. Wang. 2020. Next generation rapid diagnostic tests for meningitis diagnosis. J. Infect. 81: 712-718.
  11. Rogers, E., S. Bentley, R. Borrow, H. Bratcher, S. Brisse, A. Brueggemann, D. A. Caugant, J. Findlow, L. Fox, L. Glennie, L. H. Harrison, O. Harrison, R. S. Heyderman, M. Jansen van Rensburg, K. Jolley, R. B. Kwambana-Adams, S. Ladhani, M. LaForce, M. Levin, J. Lucidarme, J. Maclennan, M. Maiden, L. Maynard-Smith, A. Muzzi, P. Oster, C. Rodrigues, O. Ronveaux, L. Serino, V. Smith, A. van der Ende, J. Vazquez, X. Wang, S. Yezli and J. Stuart. The global meningitis genome partnership. J. Infect. 81: 510-520.
  12. Aye, A. M. M., X. Bai, R. Borrow, S. Bory, J. Carlos, D. A. Caugant, C.-S. Chiou, V. T. T. Dai, E. Cagri Dinleyici, P. Ghimire, S. Handrysastuti, J. Y. Heo, A. Jennison, H. Kamiya, T. S. L. Loong, J. Lucidarme, H. Marshall, N. D. Putri, S. Saha, Z. Shao, J. H. C. Sim, V. Smith, M.-K. Taha, P. V. Thanh, K. Tshering, U. Thisyakorn, B. Veeraraghavan, S. Yezli, and B. Zhu. 2020. Meningococcal disease surveillance in the Asia-Pacific region (2020): the Global Meningococcal Initiative. J. Infect. 81: 698-711.
  13. Willerton, L., J. Lucidarme, H. Campbell, D. A. Caugant, H. Claus, S. Jacobsson, S. N. Ladhani, P. Mölling, A. Neri, P. Stefanelli, M.-K. Taha, U. Vogel, and R. Borrow. 2020. Geographic widespread invasive meningococcal disease caused by a ciprofloxacin resistant non-groupable strain of the ST-175 clonal complex. J. Infect. 81: 575-584.
  14. Leitmeyer, K. C., L. Espinosa, E. K. Broberg, F. Allerberger, Dupont, S. Van Gucht, S. Quoilin, I. Christova, B. Hunjak, C. Karagiannis, P. Křížová, E. Møller Nielsen, J. Kähler, R. Peetso, S. Salmenlinna, T. Möttönen, B. Coignard, M. Diercke, A. Vatopoulos, Á. Tóth, K. Kristinsson, E. McNamara, A. Pantosi, V. Mavcutko, A. Griškevičius, J. Mossong, C. Barbara, T Kortbeek, D. Caugant, U. Dahle, L. Vold, A. Skoczyńska, J. Machado, G. Ionescu, L. Madarova, M. Avdičová, M. Paragi, J. Moreno Vazquez, K. Tegmark-Wisell , M. Zambon, and M. J. Struelens. 2020. Automated digital reporting of clinical laboratory information to national public health surveillance systems – results of a EU/EEA survey. Euro Surveill. 25: 1900591.
  15. Watle, S. V., D. A. Caugant, G. Tunheim, T. Bekkevold, I. Laake, O. B. Brynhildsrud, and M. Næss. 2020. Meningococcal carriage in Norwegian teenagers: strain characterization and assessment of risk factors. Epidemiol. Infect. 148: e80.
  16. Mihret W., B. Sletbakk Brusletto, R. Øvstebø, A.-M. Siebke Troseid, Norheim, Y. Merid, A. Kassu, W. Abebe, S. Ayele, M. Silamsaw Asres, L. Yamuah2, A. Aseffa, B. Petros, D. A. Caugant, P. Brandtzaeg. 2019. Molecular studies of meningococcal and pneumococcal meningitis patients in Ethiopia. Innate Immunity 25: 158-167.
  17. Greenwood, B., A. Aseffa, D. A. Caugant, K. Diallo, P. A. Kristiansen, M. C. Maiden, J. M. Stuart, and C. L. Trotter. 2019. A narrative review of methods and findings of recent carriage of meningococci and other Neisseria species in the African meningitis belt. Trop. Med. Int. Hlth. 24: 143-154.
  18. Muzzi, A., A. Brozzi, L. Serino, M. Bodini, R. Abad, D. Caugant, M. Commanducci, A. P. de Lemos, M. C. Goria, P. Krizova, C. Mikula, R. Mulhall, M. Nissen, H. Nohynek, M. Joao Simoes, A. Skoczynska, P. Stefanelli, M.-K. Taha, M. Toropainen, G. Tzanakaki, K. Vadivelu-Pechai, P. Watson, J. A. Vazquez, G. Rajam, R. Rappuoli, R. Borrow, and D. Medini. 2019. Genetic Meningococcal Antigen Typing System (gMATS): a genotyping tool that predicts 4CMenB strain coverage worldwide. Vaccine 37: 991-1000.
  19. Topaz, N., D. A. Caugant, M.-K. Taha, O. Brønstad Brynildsrud, N. Debech, E. Hong, A.-E. Deghmane, R. Ouédraogo, S. Ousmane, K. Gamougame, B.-M. Njanpop-Lafourcade, S. Diarra, L. Fox, and X. Wang. 2019. Phylogenetic relationships and regional spread of meningococcal strains in the meningitis belt, 2011-2016. EBio Medicine 41: 488-496.
  20. Krone, M., S. Gray, R. Abad Torreblanca, A. Skoczynska, P. Stefanelli, A. van der Ende, G. Tzanakaki, P. Mölling, M. J. Simões, P. Krizova, S. Emonet, D. A. Caugant, M. Toropainen, J. Vazquez, I. Wasko, C. Fazio, M. Knol, S. Jacobsson, C. Rodrigues Bettencourt, M. Musilek, R. Born, U. Vogel, and R. Borrow. Development of meningococcal serogroup W disease in Europe 2013 – 2016. Euro Surveill. 24: 1800245.
  21. Brynildsrud, O. B., V. Eldholm, A. Rakhimova, P. A. Kristiansen, and D. A. Caugant. Gauging the epidemic potential of a widely circulating non-invasive meningococcal strain in Africa. Microbial Genomics 5: e000290.
  22. Novak, R. T., J. C. Moïsi, H. Tall, M.-P. Préziosi, S. C. Hadler, N. E. Messonnier, and R. Mihigo, for the MenAfriNet Consortium. 2019. Country data for action: the MenAfriNet experience in strengthening meningitis surveillance in Africa. Infect. Dis. 220 (Suppl. 4): S137-S139.
  23. Caugant, D. A., and O. B. Brynildsrud. 2019. Neisseria meningitidis: using genomics to understand diversity, evolution and pathogenesis. Nature Rev. Microbiol. 18:84-96.
  24. Sharma, S., J. Acharya, D. A. Caugant, J. Thapa, M. Bajracharya, M. Kayastha, S. Sharma, B. S. Chalise, E. Karn, M. R. Banjara, P. Ghimire, and A. Singh. Meningococcal meningitis: a multicentric hospital-based study in Kathmandu, Nepal. Open Microbiol. J. 13: 273-278.
  25. Bai, X., R. Borrow, S. Bukovski, D. A. Caugant, D. Culic, S. Delic, E. Cagri Dinleyici, M. Eloshvili, T. Erdősi, J. Galajeva, P. Křížová, J. Lucidarme, K. Mironov, Z. Nurmatov , M. Pana, E. Rahimov, L. Savrasova, A. Skoczyńska, V. Smith, M.-K. Taha, L. Titov, J. Vázquez, and L. Yeraliyeva. Prevention and control of meningococcal disease: updates from the Global Meningococcal Initiative in Eastern Europe. J. Infect. 79: 528-541.
  26. McNeil L. K., R. G. Konrad Donald, J. Findlow, R. Borrow, P. Kriz, J. A. Vazquez, S. Li, R. Abad, M.-K. Taha, D. A. Caugant, X. Wang, J. Vuong, H. Claus, L. W. Mayer, G. W. Zlotnick, U. Vogel, M. Musilek, R. French, S. Harris, T. Jones, A. Gribenko, N. Lambert, M. W. Pride, K. U. Jansen, A. S. Anderson. Predicting the susceptibility of meningococcal serogroup B isolates to bactericidal antibodies elicited by bivalent rLP2086, a novel prophylactic vaccine. MBio 9: e00036-18.
  27. Børud, B., G. K. Bårnes, O. Brønstad Brynildsrud, E. Fritzsønn, D. A. Caugant. Genotypic and phenotypic characterization 1 of the O-linked protein glycosylation system reveals high glycan diversity in paired meningococcal carriage isolates. J. Bacteriol. 200: e00794-17.
  28. Brynildsrud, O. B., V. Eldholm, J. Bohlin, K. Uadiale, S. Obaro and D. A, Caugant. 2018. Acquisition of virulence genes by a carrier strain gave rise to the ongoing epidemics of meningococcal disease in West Africa. Proc. Acad. Sci. USA 115: 5510-5515.
  29. Bratcher H. B., C. Brehony, S. Heuberger, D. Pieridou-Bagatzouni, P. Křížová, S. Hoffmann, M. Toropainen, M.-K. Taha, H. Claus, G. Tzanakaki, T. Erdôsi, J. Galajeva, A. van der Ende, A. Skoczyńska, M. Pana, A. Vaculíková, M. Paragi, M. C. Maiden, and D. A. Caugant. 2018. Establishment of the European meningococcal strain collection genome library (EMSC-GL) for the 2011 to 2012 epidemiological year. Euro Surveill. 23: 17 00474.
  30. Caugant DA. 2018. Metagenomics for investigation of an unusual meningococcal outbreak. Lancet Infect Dis. 18: 1295-1296.
  31. Bårnes, G. K., E. Kebede Gudina, M. Berhane, A. Abdissa, G. Tesfaw, G. Abebe, S. L. Feruglio, D. A. Caugant, and H. J. Jørgensen. 2018. New molecular tools for meningitis diagnostics in Ethiopia - a necessary step towards improving antimicrobial prescription. BMC Infect. Dis.18: 684.
  32. Acevedo, R., X. Bai, Borrow, D. A. Caugant, J. Carlos, M. Ceyhan, H. Christensen, Y. Climent, P. De Wals, E. Cagri Dinleyici, G. Echaniz-Aviles, A. Hakawi, H. Kamiya, A. Karachaliou, J. Lucidarme, S. Meiring, K. Mironov, M. A.P. Sáfadi, Z. Shao, V. Smith, R. Steffen, B. Stenmark, M.-K. Taha, C. Trotter, J. A. Vázquez, and B. Zhu. 2018. The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations. Expert Rev. Vaccines. 18: 15-30.
  33. Whittaker R., J. Gomes Dias, M. Ramliden, C. Ködmöen, A. Economopoulou, N. Beer, L. Pastore Celentano, the ECDC network members for invasive meningococcal disease. 2017. The epidemiology of invasive meningococcal disease in EU/EEA countries, 2004-2014. Vaccine 35: 2034-2041.
  34. Revez, J., L. Espinosa, B. Albiger, K. C. Leitmeyer, M. J. Struelens, and ECDC National Microbiology Focal Points and Experts Group. 2017. Survey on the use of Whole Genome Sequencing for infectious diseases surveillance: rapid expansion of European national capacities, 2015-2016. Front. Public Health 5: 347.
  35. Page, A.-L., M. E. Coldiron, K. Gamougam, M. A. Acyl, M. Tamadji, N. Hurtado, F.-C. Tehoua, F. Fermon, D. A. Caugant, and K. Porten. 2017. Three years of case-based surveillance of meningitis following the introduction of MenAfriVac in Moissala, Chad: lessons learned. Trop. Med. Int. Hlth. 22: 1561-1568.
  36. Kretz, C. B., A. C. Retchless, F. Sidikou, M. Zaneidou, B. Isaaka, S. Ouseman, S. Schwartz, A. H. Tate, A. Pana, B. Njanpop-Lafourcade, I. Nzeyimana, R. Obama Nse, A.-E. Deghmane, E. Hong, O. Brønstad Brynildsrud, R. T. Novak, S. Meyer, G. Kadade, O. Ouwe Missi Oukem, O. Ronveaux, D. A. Caugant, M.-K. Taha, X. Wang, and Niger Response Team. 2016.Whole genome characterization of the emerging epidemic meningococcal serogroup C and resurgence of serogroup W in Niger, 2015. Infec. Dis. 22: 1762-1768.
  37. Uadiale, K., A. Bestman, C. Kamau, D. A. Caugant, and J. Greig. Evaluation of Pastorex meningitis kit performance for the rapid identification of Neisseria meningitidis serogroup C in Nigeria. Trans. R. Soc. Trop. Med. Hyg. 110: 381-385.
  38. Chow, J., K. Uadiale, A. Bestman, C. Kamau, D. A. Caugant, A. A. Koko, A. Shehu, and J. Greig. Invasive meningococcal meningitis serogroup C outbreak in Northwest Nigeria, 2015 – third consecutive outbreak of a new strain. PLoS Curr. Outbreaks July 7:8.
  39. Bårnes, G. K., P. A. Kristiansen, D. Beyene, B. Workalemahu, P. Fisshia, B. Merdekios, J. Bohlin, A. Aseffa, and D. A. Caugant. 2016. Prevalence and epidemiology of meningococcal carriage in Southern Ethiopia prior to implementation of MenAfriVac, a conjugate vaccine. BMC Infect. Dis. 16: 639-652.
  40. Borrow, R., P. Alarcón, J. Carlos, D. A. Caugant, H. Christensen, R. Debbag, P. de Wals, G. Echániz-Aviles, J. Findlow, C. Head, D. Holt, H. Kamiya, S. K. Saha, S. Sidorenko, M.-K. Taha, C. Trotter, J. A. Vazquez Moreno, A. von Gottberg, and M. A. P. Sáfadi; on behalf of the Global Meningitis Initiative. 2017. The Global Meningococcal Initiative: currents strategies for the prevention of meningococcal disease and the importance of herd protection. Expert Rev. Vaccines 16: 313-328.
  41. Borrow, R., D. A. Caugant, M. Ceyhan, H. Christensen, E. C. Dinleyici, J. Findlow, L. Glennie, A. Von Gottberg, A. Kechrid, J. Vázquez Moreno, A. Razki, V. Smith, M.-K.Taha, H. Tali-Maamar, K. Zerouali; Global Meningococcal Initiative (GMI). 2017. Meningococcal disease in the Middle East and Africa: Findings and updates from the Global Meningococcal Initiative. J Infect. 75: 1-11.
  42. Diallo, K., K. Gamougam, M. Daugla, O. B. Harrison, J. E. Bray, D. A. Caugant, J. Lucidarme, C. L. Trotter, M. Hassan-King, J. M. Stuart, O. Manigart, B. M. Greenwood, and M. C. J. Maiden. 2017. Hierarchical genomic analysis of carried and invasive serogroup A Neisseria meningitidis during the 2011 epidemic in Chad. BMC Genomics 18: 398.
  43. Bårnes, G. K., O. Brønstad Brynildsrud, B. Børud, B. Workalemahu, P. A. Kristiansen, D. Beyene, A. Aseffa, and D. A. Caugant. 2017. Whole genome sequencing reveals within-host genetic changes in paired meningococcal carriage isolates from Ethiopia. BMC Genomics 18: 407.
  44. Mihret, W., T. Lema, Y. Merid, A. Kassu, W. Abebe, B. Moges, A. Tenna, F. Woldegebriel, M. Yidnekachew, W. Mekonnen, A. Ahmed, L. Yamuah, M. Selamsew, B. Petros, J. Oksnes, E. Rosenqvist, S. Ayele, A. Aseffa, D. A. Caugant, and G. Norheim. Surveillance of bacterial meningitis, Ethiopia, 2012-2013. Emerg. Infec. Dis. 22: 75-78.
  45. Bårnes, G. K., B. Workalemahu, P. A. Kristiansen, D. Beyene, M. Behailu, P. Fissiha, A. Aseffa, D. A. Caugant and L. M. Naess. 2016. Salivary and serum antibody response against Neisseria meningitidis after vaccination with conjugate polysaccharide vaccines in Ethiopian volunteers. Scand. J. Immunol. 84: 118-129.
  46. Bårnes, G. K., P. A. Kristiansen, D. A. Caugant and L. M. Næss. 2015. Development and evaluation of a multiplex microsphere assay for quantification of IgG and IgA antibodies against Neisseria meningitidis Serogroup A, C, W and Y polysaccharides. CVI 22: 697-705.
  47. Kristiansen, P. A., H. J. Jørgensen, and D. A. Caugant. 2015. Serogroup A meningococcal conjugate vaccines in Africa. Expert Rev. Vaccines 14: 1441-1458.
  48. Diomandé, F. V. K., M. H. Djingarey, D. M. Daugla, R. T. Novak, P. A. Kristiansen, J.-M. Collard, K. Gamougam, D. Kandolo, N. Mbakuliyemo, L. Mayer, J. Stuart, T. Clark, C. Tevi-Benissan, W. Perea, M.-P. Préziosi, M. LaForce, D. Caugant, N. Messonnier, O. Walker, and B. Greenwood. 2015. Public health impact after introduction of PsA-TT: the first 4 years. Clin. Infect. Dis. 61(Suppl. 5): S467-S472.
  49. Gamougam, K., D. M. Dougla, J. Toralta, C. Ngadoua, F. Fermon, A.-L. Page, M. H. Djingarey, O. Manigart, C. L. Trotter, J. M. Stuart, and B. M. Greenwood. Continuing impact of PsA-TT vaccine on serogroup A meningococcal meningitis in Chad. Emerg. Infec. Dis. 21: 115-118.
  50. Harrison, O. B., J. E. Bray, M. C. J. Maiden, and D. A. Caugant. 2015. Genomic analysis of the evolution and global spread of the hyper-invasive meningococcal lineage 5. EBio Medicine 2: 234-243.
  51. Funk, A., K. Uadiale, C. Kamau, D. A. Caugant, and J. Greig. Sequential outbreaks due to a new strain of Neisseria meningitidis serogroup C in northern Nigeria, 2013-14. PLOS Currents Outbreaks pp.1-6.
  52. Kristiansen, P. A., A. Ky Ba, A. Salam Ouédraogo, I. Sanou, R. Ouédraogo, L. Sangaré, F. Diomandé, D. Kandolo, I. M. Saga, L. Misegades, T. A. Clark, M.-P. Préziosi, and D. A. Caugant. 2014. Still low carriage of serogroup A Neisseria meningitidis two years after mass vaccination with the meningococcal conjugate vaccine, MenAfriVac. BMC Infect. Dis. 14: 663.

History

03.01.2023: Text reviewed and updated by Prof. Caugant