{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:35:41Z","timestamp":1761514541598,"version":"3.41.2"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:00:00Z","timestamp":1583193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Salem bin Mahfouz Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Intense congestion during the Hajj pilgrimage amplifies the risk of meningococcal carriage and disease, and there have been many meningococcal outbreaks reported amongst pilgrims. Thus, a strict vaccination policy is enforced by the host country and either polysaccharide or conjugate quadrivalent meningococcal vaccines are mandatory. However, unlike conjugate vaccines, the polysaccharide vaccine is not thought to reduce pharyngeal carriage of meningococci.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A single-blinded, randomized, controlled trial amongst pilgrims from Saudi Arabia and Australia during the Hajj seasons of 2016\u20132017 was conducted to compare MenACWY-Conjugate vaccine with MenACWY-Polysaccharide vaccine, to determine if the conjugate vaccine is more effective in reducing asymptomatic carriage of meningococci, and whether the effect may be long-standing. Oropharyngeal swabs were obtained pre-, immediately post- and 6\u201311\u00a0months following completion of Hajj and tested for the presence of meningococci.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Amongst 2000 individuals approached, only 1146 participants aged 18\u201391 (mean 37.6) years agreed to participate and were randomized to receive either the polysaccharide (n\u2009=\u2009561) or the conjugate (n\u2009=\u2009561) vaccine, 60.8% were male, and 93.5% were from Saudi Arabia. Amongst oropharyngeal swabs obtained before Hajj, only two (0.2%) tested positive for Neisseria meningitidis. Similarly, meningococci were identified in only one sample at each of the post-Hajj and late follow-up visits. None of the carriage isolates were amongst the serogroups covered by the vaccines. A post hoc analysis of the third swabs revealed that 22.4% of all participants (50\/223) were positive for Streptococcus pneumoniae nucleic acid.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The low overall carriage rate of meningococci found amongst Hajj pilgrims in 2016 and 2017 demonstrates a successful vaccination policy, but neither supports nor refutes the superiority of meningococcal conjugate ACWY vaccine over the polysaccharide vaccine against carriage. Although an association could not be established in this study, molecular epidemiology would help to establish the role of Hajj in facilitating transmission of pneumococci and inform vaccination policy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taaa032","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T17:12:29Z","timestamp":1583255549000},"source":"Crossref","is-referenced-by-count":6,"title":["Meningococcal and pneumococcal carriage in Hajj pilgrims: findings of a randomized controlled trial"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7421-6435","authenticated-orcid":false,"given":"Al-Mamoon","family":"Badahdah","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 22252, Saudi Arabia"},{"name":"National Centre for Immunisation Research and Surveillance (NCIRS), The Children\u2019s Hospital at Westmead, NSW 2145, Australia"},{"name":"The Discipline of Child and Adolescent Health, The Children\u2019s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan A","family":"Bakarman","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 22252, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameneh","family":"Khatami","sequence":"first","affiliation":[{"name":"The Discipline of Child and Adolescent Health, The Children\u2019s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Department of Infectious Diseases and Microbiology, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1669-1494","authenticated-orcid":false,"given":"Mohamed","family":"Tashani","sequence":"first","affiliation":[{"name":"The Discipline of Child and Adolescent Health, The Children\u2019s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Faculty of Medicine, University of Tripoli, Ain Zara, Tripoli, Libya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamah","family":"Barasheed","sequence":"first","affiliation":[{"name":"The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Alfelali","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 22252, Saudi Arabia"},{"name":"National Centre for Immunisation Research and Surveillance (NCIRS), The Children\u2019s Hospital at Westmead, NSW 2145, Australia"},{"name":"The Discipline of Child and Adolescent Health, The Children\u2019s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad I","family":"Azeem","sequence":"first","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance (NCIRS), The Children\u2019s Hospital at Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamid","family":"Bokhary","sequence":"first","affiliation":[{"name":"Umm Al-Qura University, Makkah, Saudi Arabia"},{"name":"Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Soltan","sequence":"first","affiliation":[{"name":"Microbiology department, Al Borg Medical Laboratories, Jeddah 21573, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica M","family":"Lahra","sequence":"first","affiliation":[{"name":"The World Health Organisation Collaborating Centre for STI and AMR, and Neisseria Reference Laboratory, New South Wales Health Pathology, Microbiology, Prince of Wales Hospital, Randwick, NSW, 2031, Australia"},{"name":"Faculty of Medicine, The University of New South Wales, Randwick, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neisha","family":"Jeoffreys","sequence":"first","affiliation":[{"name":"New South Wales Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital and University of Sydney, Westmead NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen","family":"Kok","sequence":"first","affiliation":[{"name":"New South Wales Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital and University of Sydney, Westmead NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic E","family":"Dwyer","sequence":"first","affiliation":[{"name":"New South Wales Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital and University of Sydney, Westmead NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Booy","sequence":"first","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance (NCIRS), The Children\u2019s Hospital at Westmead, NSW 2145, Australia"},{"name":"The Discipline of Child and Adolescent Health, The Children\u2019s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harunor","family":"Rashid","sequence":"first","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance (NCIRS), The Children\u2019s Hospital at Westmead, NSW 2145, Australia"},{"name":"The Discipline of Child and Adolescent Health, The Children\u2019s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Hajj Research 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