Carriage Rate of Neisseria meningitidis, Antibiotic Susceptibility Pattern and Associated Risk Factors among Primary School Children in Gondar town, Northwest Ethiopia

Abstract Background Invasive meningococcal disease has 70–80% mortality. Globally, 1.2 million estimated cases were reported with ~135,000 deaths annually. In African meningitis belt bacterial meningitis remains a serious threat to health accounting an estimated 500,000 cases of invasive meningococcal disease annually.In Ethiopia, specifically in our study area, limited information is found on the oropharyngeal carriage, antimicrobial resistance pattern and associated risk factors for N. meningitidis especially in school children. So, the aim of this study was to assess oropharyngeal carriage rate of N. meningitidis, antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia. Methods A cross sectional prospective study was conducted from January-April, 2019 among primary school children. Multi stage simple random sampling technique was used. A total of 524 oropharyngeal swabs were collected using sterile plastic cotton swabs. Modified Thayer Martin media was used for primary inoculation. Antimicrobial susceptibility pattern was done on Muller-Hinton agar supplemented with 5% sheep blood. Logistic regression model was used to see the association between dependent and independent variables. P ≤0.05 at 95% CI was considered as statistically significant. Results A total of 53(10.1%) (CI: 7.6-12.8) N. meningitidis isolates were identified. Serogroup A 13 (24.5%) was the most prevalent followed by Y/W135 11(20.7%) whereas serogroup B 4(7.6%) was the least identified. Meningococcal isolates were resistant to ciprofloxacin (45.3%) and trimethoprim-sulfamethoxazole (73.6%). Overall, most of meningococcal isolates showed high level of multidrug resistance with the rate of 32(60.4%). Meningococcal carriage rate was associated with family size, tonsillectomy, passive smoking, number of students per class, sharing utensils, history of visiting healthcare institutions and indoor kitchen. Conclusion Neisseria meningitidis prevalence in the present study was high. Serogroup A and W135/Y was the most prevalent isolate. High multidrug resistance pattern was observed.