Dynamic characteristics of Neisseria meningitidis carriage among new students in boarding martial arts schools: a longitudinal follow-up study
5 affiliations
- 1Institute for Immunization Prevention and Programme, Henan Provincial Center for Disease Control and Prevention
- 2Henan Preventive Medicine Institute
- 3School of Public Health, Zhengzhou University
- 4Department of Immunization Program, Zhengzhou Municipal Center for Disease Control and Prevention
- 5Department of Immunization Program, Dengfeng Municipal Center for Disease Control and Prevention
Abstract
Objective: This study aimed to characterize the dynamic patterns of Neisseria meningitidis (Nm) carriage, identify factors influencing Nm acquisition and clearance, and provide empirical evidence for understanding the epidemiological mechanisms of Nm carriage and for developing targeted prevention strategies.
Methods: A prospective cohort of 60 new entrants was established at a boarding martial arts school in Dengfeng City from February to December 2025. Oropharyngeal swabs were collected at regular intervals and subjected to laboratory testing. A hidden Markov model (HMM) was applied to estimate acquisition and clearance rates of Nm, and proportional hazards models were used to assess the effects of covariates on these rates.
Results: A total of 13 follow-up visits and samplings were completed. The Nm carriage prevalence ranged from 30.00 to 93.75%, showing an overall upward trend, with serogroups B and X being predominant. During the observation period, 52.54% (31/59) of positive carriers exhibited ≥2 carriage episodes, and 35.59% (21/59) carried ≥2 serogroups over time. The mean carriage duration was estimated at 7.38 months (95% CI: 4.18–13.01). For Nm acquisition, individuals aged ≥15 years had a higher acquisition rate than those aged <15 years (HR = 2.01, 95% CI: 0.99–4.08), and those with a smoking history showed a higher acquisition rate than non-smokers (HR = 1.48, 95% CI: 0.76–2.91), although the latter difference was not statistically significant. For Nm clearance, age ≥15 years (HR = 4.40, 95% CI: 1.49–13.00) and fever in the past week (HR = 4.16, 95% CI: 1.36–12.75) were significantly associated with higher clearance rates. Smoking history (HR = 3.39, 95% CI: 0.92–12.53) and antibiotic use (HR = 2.58, 95% CI: 0.74–9.05) also suggested potential associations with increased clearance, but these did not reach statistical significance.
Conclusion: New entrants in this boarding martial arts school exhibited a high risk of Nm carriage, with prolonged average carriage duration and frequent serogroup switching during carriage episodes. Age ≥15 years and recent fever were significantly associated with enhanced Nm clearance. These findings underscore the need for strengthened health surveillance and behavioral interventions to reduce the risk of persistent carriage and onward transmission in such congregate settings.
Related
- Septic Arthritis of the Knee Caused by Neisseria meningitidis Serogroup Y
- Arf1 is involved in Neisseria meningitidis-induced cortical branched F-actin network reorganization
- Neisseria meningitidis serogroup X polysaccharide as a qualified antigen for multivalent meningococcal conjugate vaccines
- Emergence of short-lived meningococci causing focal epidemics can be associated with gene transfer from carriage-associated Neisseria
- What students ask matters: Static and longitudinal questioning patterns in student–LLM dialogue and self-reported cognitive engagement
BibTeX
@article{li2026dynamic,
title = {{Dynamic characteristics of Neisseria meningitidis carriage among new students in boarding martial arts schools: a longitudinal follow-up study}},
author = {Jun Li and Yingying Liu and Jiangnan Kong and Xiaoli Wang and Tian Tian and Xiangyang Zhang and Xiaoxiao Zhang and Yanfang Ji and Yonghao Guo and Qian Liu and Shuaiyin Chen and Yanyang Zhang},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1941998},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1941998/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Dynamic characteristics of Neisseria meningitidis carriage among new students in boarding martial arts schools: a longitudinal follow-up study
AU - Jun Li
AU - Yingying Liu
AU - Jiangnan Kong
AU - Xiaoli Wang
AU - Tian Tian
AU - Xiangyang Zhang
AU - Xiaoxiao Zhang
AU - Yanfang Ji
AU - Yonghao Guo
AU - Qian Liu
AU - Shuaiyin Chen
AU - Yanyang Zhang
PY - 2026
DA - 2026/10/22
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1941998
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1941998/full
AB - Objective: This study aimed to characterize the dynamic patterns of Neisseria meningitidis (Nm) carriage, identify factors influencing Nm acquisition and clearance, and provide empirical evidence for understanding the epidemiological mechanisms of Nm carriage and for developing targeted prevention strategies. Methods: A prospective cohort of 60 new entrants was established at a boarding martial arts school in Dengfeng City from February to December 2025. Oropharyngeal swabs were collected at regular intervals and subjected to laboratory testing. A hidden Markov model (HMM) was applied to estimate acquisition and clearance rates of Nm, and proportional hazards models were used to assess the effects of covariates on these rates. Results: A total of 13 follow-up visits and samplings were completed. The Nm carriage prevalence ranged from 30.00 to 93.75%, showing an overall upward trend, with serogroups B and X being predominant. During the observation period, 52.54% (31/59) of positive carriers exhibited ≥2 carriage episodes, and 35.59% (21/59) carried ≥2 serogroups over time. The mean carriage duration was estimated at 7.38 months (95% CI: 4.18–13.01). For Nm acquisition, individuals aged ≥15 years had a higher acquisition rate than those aged <15 years (HR = 2.01, 95% CI: 0.99–4.08), and those with a smoking history showed a higher acquisition rate than non-smokers (HR = 1.48, 95% CI: 0.76–2.91), although the latter difference was not statistically significant. For Nm clearance, age ≥15 years (HR = 4.40, 95% CI: 1.49–13.00) and fever in the past week (HR = 4.16, 95% CI: 1.36–12.75) were significantly associated with higher clearance rates. Smoking history (HR = 3.39, 95% CI: 0.92–12.53) and antibiotic use (HR = 2.58, 95% CI: 0.74–9.05) also suggested potential associations with increased clearance, but these did not reach statistical significance. Conclusion: New entrants in this boarding martial arts school exhibited a high risk of Nm carriage, with prolonged average carriage duration and frequent serogroup switching during carriage episodes. Age ≥15 years and recent fever were significantly associated with enhanced Nm clearance. These findings underscore the need for strengthened health surveillance and behavioral interventions to reduce the risk of persistent carriage and onward transmission in such congregate settings.
SN - 2296-2565
ER -