Prevalence and Risk of Meningococcal Disease or Carriage During Mass Gatherings and Associated Travel: Systematic Review and Meta-Analysis.

BACKGROUND

While efforts have been made to control meningococcal disease or carriage during mass gatherings (MGs), it is still a significant problem. This meta-analysis aims to assess the prevalence and predictors of meningitis carriage during MGs and travel.

METHODOLOGY: PubMed, Scopus, Embase, and Cochrane were searched from their conception to January 2025. Cohort and cross-sectional studies assessing the prevalence of meningitis carriage and its serotype related to MGs and/or travel, and risk factors associated with its spread, were considered. The Newcastle-Ottawa scale was used for the quality assessment of studies.

RESULTS

Out of 1301 studies, 25 were considered for this meta-analysis. The largest geographic area involved was Saudi Arabia. A meta-analysis of 24 studies identified a pooled prevalence rate of meningococcal disease or carriage of 15.9% (95%CI: 4.45-27.4%) and the most frequent infecting organisms to be Serotype C (13.9%; 95%CI: -14.7 to 42.5; 4 studies) and A (11.5%; 95%CI: -2.13 to 25.2; 9 studies) among those at MGs or traveling. Age, gender, smoking history, and the vaccination status did not affect the infection risk.

CONCLUSIONS

There is an increased prevalence of meningococcal disease and carriage, especially Serogroups A and C, associated with MGs and travel. New interventions and methodologies should be undertaken to control and prevent meningococcal disease or carriage transmission during such events.