Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study

Objective The Xinjiang Uygur Autonomous Region (Xinjiang) currently exhibits the high incidence rates of invasive meningococcal disease (IMD) in China. Current epidemiological data on meningococcal carriage rates among asymptomatic individuals remain sparse, with limited population-based studies sys...

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Main Authors: Halimubieke Nazhaerbieke, Wenhui Fu, Zhaoguo Lan, Yesitai Muheiyati, Tian Tian, Caipilima Wuqierjiafu, Na Xie
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Language:English
Published: PeerJ Inc. 2025-07-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19772.pdf
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author Halimubieke Nazhaerbieke
Wenhui Fu
Zhaoguo Lan
Yesitai Muheiyati
Tian Tian
Caipilima Wuqierjiafu
Na Xie
author_facet Halimubieke Nazhaerbieke
Wenhui Fu
Zhaoguo Lan
Yesitai Muheiyati
Tian Tian
Caipilima Wuqierjiafu
Na Xie
author_sort Halimubieke Nazhaerbieke
collection DOAJ
description Objective The Xinjiang Uygur Autonomous Region (Xinjiang) currently exhibits the high incidence rates of invasive meningococcal disease (IMD) in China. Current epidemiological data on meningococcal carriage rates among asymptomatic individuals remain sparse, with limited population-based studies systematically investigating the prevalence of Neisseria meningitidis colonization in the general population. This study employs a dual-pronged epidemiological approach to systematically characterize the clinical-epidemiological profile of IMD in Xinjiang and quantify the nasopharyngeal carriage prevalence of N. meningitidis among asymptomatic populations, while identifying region-specific sociodemographic and behavioral determinants of carriage dynamics. Methods Epidemiological characteristics were analyzed using descriptive epidemiological methods. N. meningitidis strains isolated from asymptomatic carriers underwent serogroup characterization via multiplex real-time polymerase chain reaction (real-time PCR) targeting conserved capsular biosynthesis loci (serogroups A, B, C, W, X, and Y), with reaction conditions optimized per WHO standardized protocols for meningococcal molecular typing. The ${\chi^2}$χ2 test was used to compare the N. meningitidis carriage rates. A multivariable logistic regression model was used to analyze the risk factors associated with the carriage of N. meningitidis. Results From 2004 to 2023, 1,100 cases of IMD were reported in Xinjiang, with the annual incidence rate fluctuating between 0.00/100,000 and 1.15/100,000 per year. The peak incidence occurred from February to May. The incidence was primarily concentrated in individuals under 20 years old (80.36%). Among 3,075 oropharyngeal swab specimens analyzed, 411 (13.37%; 95% CI [12.18–14.62]) yielded culture-confirmed N. meningitidis isolates. Serogroup B (168, 40.88%) emerged as the predominant meningococcal serogroup. Binomial multivariate logistic regression analyses indicated significant associations between the carriage rate of N. meningitidis and age, sex, year, region, and vaccination history (p < 0.05). Conclusion Epidemiological surveillance data from 2004 to 2023 revealed a significant decline in the incidence of IMD across Xinjiang, with the epidemiological profile transitioning from cyclic epidemic peaks to sporadic case clusters. Despite this decline, the carriage rate of N. meningitidis remained at elevated levels among healthy populations. The risk of carrying N. meningitidis was relatively high among the healthy population in the southern region of Xinjiang, people aged over 16, and those without a vaccination history. Strengthening IMD surveillance in high-risk areas is essential to prevent future outbreaks.
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spelling doaj-art-8e3f48d9506e4b3b99450ef8eaac15b02025-08-20T03:58:35ZengPeerJ Inc.PeerJ2167-83592025-07-0113e1977210.7717/peerj.19772Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective studyHalimubieke Nazhaerbieke0Wenhui Fu1Zhaoguo Lan2Yesitai Muheiyati3Tian Tian4Caipilima Wuqierjiafu5Na Xie6Department of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang Uygur Autonomous Region, ChinaObjective The Xinjiang Uygur Autonomous Region (Xinjiang) currently exhibits the high incidence rates of invasive meningococcal disease (IMD) in China. Current epidemiological data on meningococcal carriage rates among asymptomatic individuals remain sparse, with limited population-based studies systematically investigating the prevalence of Neisseria meningitidis colonization in the general population. This study employs a dual-pronged epidemiological approach to systematically characterize the clinical-epidemiological profile of IMD in Xinjiang and quantify the nasopharyngeal carriage prevalence of N. meningitidis among asymptomatic populations, while identifying region-specific sociodemographic and behavioral determinants of carriage dynamics. Methods Epidemiological characteristics were analyzed using descriptive epidemiological methods. N. meningitidis strains isolated from asymptomatic carriers underwent serogroup characterization via multiplex real-time polymerase chain reaction (real-time PCR) targeting conserved capsular biosynthesis loci (serogroups A, B, C, W, X, and Y), with reaction conditions optimized per WHO standardized protocols for meningococcal molecular typing. The ${\chi^2}$χ2 test was used to compare the N. meningitidis carriage rates. A multivariable logistic regression model was used to analyze the risk factors associated with the carriage of N. meningitidis. Results From 2004 to 2023, 1,100 cases of IMD were reported in Xinjiang, with the annual incidence rate fluctuating between 0.00/100,000 and 1.15/100,000 per year. The peak incidence occurred from February to May. The incidence was primarily concentrated in individuals under 20 years old (80.36%). Among 3,075 oropharyngeal swab specimens analyzed, 411 (13.37%; 95% CI [12.18–14.62]) yielded culture-confirmed N. meningitidis isolates. Serogroup B (168, 40.88%) emerged as the predominant meningococcal serogroup. Binomial multivariate logistic regression analyses indicated significant associations between the carriage rate of N. meningitidis and age, sex, year, region, and vaccination history (p < 0.05). Conclusion Epidemiological surveillance data from 2004 to 2023 revealed a significant decline in the incidence of IMD across Xinjiang, with the epidemiological profile transitioning from cyclic epidemic peaks to sporadic case clusters. Despite this decline, the carriage rate of N. meningitidis remained at elevated levels among healthy populations. The risk of carrying N. meningitidis was relatively high among the healthy population in the southern region of Xinjiang, people aged over 16, and those without a vaccination history. Strengthening IMD surveillance in high-risk areas is essential to prevent future outbreaks.https://peerj.com/articles/19772.pdfInvasive meningococcal diseaseNeisseria meningitidisSerogroupEpidemiological characteristicCarriage
spellingShingle Halimubieke Nazhaerbieke
Wenhui Fu
Zhaoguo Lan
Yesitai Muheiyati
Tian Tian
Caipilima Wuqierjiafu
Na Xie
Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study
PeerJ
Invasive meningococcal disease
Neisseria meningitidis
Serogroup
Epidemiological characteristic
Carriage
title Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study
title_full Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study
title_fullStr Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study
title_full_unstemmed Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study
title_short Epidemiological characteristics of invasive meningococcal disease and carriage prevalence of Neisseria meningitidis in the Xinjiang Uygur Autonomous Region, China, 2004–2023: a retrospective study
title_sort epidemiological characteristics of invasive meningococcal disease and carriage prevalence of neisseria meningitidis in the xinjiang uygur autonomous region china 2004 2023 a retrospective study
topic Invasive meningococcal disease
Neisseria meningitidis
Serogroup
Epidemiological characteristic
Carriage
url https://peerj.com/articles/19772.pdf
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