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Table 1 Asymptomatic carriage rate of meningococcal disease (EM region only)

From: Systematic review of invasive meningococcal disease epidemiology in the Eastern Mediterranean and North Africa region

References Study design Setting (region) Population
Total number of swabbed persons
Asymptomatic carriage rate (%)
Year Age category (age range) Serogroup
Turkey [27] Cross-sectional study 6 well child clinics, 11 day-care centres and 7 elementary schools (Anatolian side of Istanbul) General population
N = 1382
2000: 1.2 Children (0–10 y): 1.2 All: 1.2
- A: 0.1
- B: 0.4
- C: 0.0
- W135: 0.1
- Y: 0.7
- Other: 0.1
Turkey [28] Cross-sectional study Primary schools in the city centre (Manisa) General population
N = 1128
2001–2002: 4.8–8.0 Children (7–14 y): 4.8–8.0 All: 4.8–8.0
- A: 1.8
- B: 1.4
- C: 2.2
- W135: 0.7
- Other: 0.2
Turkey [29] Cross-sectional study Marmara University Pendik Training and Research Hospital (Istanbul) General population
N = 1000
2012–2013: 0.6 Children and adults (0–79 y): 0.6 All: 0.6
- B: 0.5
- Other: 0.1
Turkey [31] Cross-sectional study 13 sites (12 Turkish provinces) General population
N = 1518
2015: 2.8–11.0 Children (10–17 y): 2.8–11.0 All: 2.8–11.0
- A: 0.3
- B: 0.6
- C: 0.0
- W135: 4.2
- Y: 0.3
- Other: 0.9
Adults (18–20 y): 3.1–10.3
Children and adults (10–24 y): 6.3
Turkey [32] Cross-sectional study Ýnönü University Faculty of Medicine hospital (Malatya) General population
N = 77
2006: 1.3 Adults (18–62 y): 1.3 All: 1.3
Turkey [30] Cross-sectional study City (Diyarbakir) General population
N = 255
2004: 2.4–2.8 Children (0–14 y): 2.8 All: 2.4–2.8
- W135: 0.4
- Other: 0.4
Adults (20–70 y): 2.5
Iran [33] Longitudinal study Shiraz airport before and after the Hajj (Shiraz) Pilgrims
N = 674 (before Hajj 2003)
N = 674 (post Hajj 2003)
Hajj study
Before Hajj 2003: 5.2 Adults (NR): 5.2 All: 5.2
- A: 0
- B: 1.3
- C: 0.7
- W135: 0.1
- Y: 0.7
- Other: 0.0–1.5
Post Hajj 2003: 4.6 Adults (NR): 4.6 All: 4.6
- A: 0.1
- B: 0.3
- C: 0.1
- W135: 0.1
- Y: 0.3
- Other: 0.0–3.1
Iran [34] Cross-sectional study Military for vaccination in hospital (NR) Military
N = 226
2014–2015: 8.0 Adults (19–28 y): 8.0 All: 8.0
- A: 1.8
- C: 4.0
- W135: 0.4
- Y: 1.3
- Other: 0.4
Iran [35] Longitudinal study Military training centre (south-east of Iran) Military
N = 764 (1st sample)
N = 692 (2nd sample)
1st sample 2002–2003: 11.4 1st sample 2002–2003
Adults (18–≥ 20 y): 11.4
1st sample 2002–2003
All: 11.4
2nd sample 2002–2003: 32.9 2nd sample 2002–2003
Adults (18–≥ 20 y): 32.9
2nd sample 2002–2003
All: 32.9
Iran [36] Longitudinal study Waiting hall of the airport before and after the Hajj (Zahedan) Pilgrims
N = 422 (before Hajj 2012)
N = 422 (post Hajj 2012)
Hajj study
Before Hajj 2012: 0 Before Hajj
Adults (21–95 y): 0
Before Hajj
All: 0
Post Hajj 2012: 1.4 Post Hajj
Adults (21–95 y): 1.4
Post Hajj
All: 1.4
Iran [37] Cross-sectional study 3 dormitories affiliated with Kerman University of Medical Sciences (Kerman) University students
N = 335
2017–2018: 6.9 Adults (18–34 y): 6.9 All: 6.9
- C: 3.0
- Other: 3.9
Iran [38] Cross-sectional study 16 schools (Kashan) Students
N = 115
2011–2012: 6.0–12.3 Children (7–14 y): 6.0–7.1 All: 8.9
- B: 0.6
- C: 8.3
Children and adults (7–19 y): 8.9–12.3
Kuwait [39] Cross-sectional study Pilgrims who attended a post-Hajj gathering (NR) Pilgrims
N = 177
Hajj study
2005: 0.0 Adults (NR): 0.0 All: 0.0
Saudi Arabia [43] Longitudinal study King Khalid National Guard Hospital (Mecca/Jeddah area) Pilgrims and hospital personnel
N = 190 (before Hajj 2001)
N = 137 (post Hajj 2001)
Hajj study
Before Hajj 2001: 7.4 Before Hajj 2001
Adults (18–61 y): 7.4
Before Hajj 2001
All: 7.4
- A: 0.5
- B: 1.1
- W135: 2.6
- Other: 0.5–2.6
Post Hajj 2001: 0.7 Post Hajj 2001
Adults (18–61 y): 0.7
Post Hajj 2001
All: 0.7
- A: 0
- B: 0
- W135: 0.7
- Other: 0.0
Saudi Arabia [42] Cross-sectional study Mina Hospital outpatient clinics (Mina) Pilgrims
N = 344
Hajj study
2003: 1.6–4.3 Children (0–19y): 3.0 All: 1.6–4.3
- B: 0.3
- W135: 0.6
- Other: 2.3
Adults (20–> 40 y): 1.6–4.3
Children and adults (0–> 40 y): 3.2
Saudi Arabia [44] Cohort study Arriving pilgrims: Hajj Terminal of the King Abdul Aziz International Airport (Jeddah); departing pilgrims: tents for Hajj pilgrims (Mina) Pilgrims
N = 1055 (unpaired arriving pilgrims 2014)
N = 373 (unpaired departing pilgrims 2014)
N = 628 (paired cohort arriving and departing pilgrims 2014)
Hajj study
I. Unpaired arriving pilgrims 2014: 3.4 I. Adults (18–> 65 y): 3.4 I. All: 3.4
- B: 2.3
- Other: 1.1
II. Unpaired departing pilgrims 2014: 1.6 II. Adults (> 18–100 y): 1.6 II. All: 1.6
- B: 0.5
- Other: 1.1
IIIa. Paired cohort arriving pilgrims 2014: 2.5 IIIa. Adults (18–> 65 y): 2.5 IIIa. All: 2.5
- B: 2.2
IIIb. Paired cohort departing pilgrims 2014: 1.3 IIIb. Adults (18–> 65 y): 1.3 IIIb. All: 1.3
- B: 1.3
Saudi Arabia [40] Cross-sectional study King Abdul Aziz International Airport, King Khalid International Airport, camping (Jeddah Riyadh, Mina) Pilgrims
N = 715 (before Hajj)
N = 745 (post Hajj)
Hajj study
Before Hajj 2000: 8.0 Before Hajj 2000
Adults (18–100 y): 8.0
Before Hajj 2000
All: 8.0
- A: 0.4
- B: 1.3
- W135: 0.4
- Y: 0.6
- Other: 5.2
Post Hajj 2000: 10.4 Post Hajj 2000
Adults (18–100 y): 10.4
Post Hajj 2000: 10.4
- A: 0.0
- B: 0.4
- W135: 4.6
- Y: 0.0
- Other: 5.2
Saudi Arabia [41] Longitudinal study King Abdul-Aziz International Airport (Jeddah) Pilgrims
Umra visitors
N = 979 (before Umra)
N = 979 (post Umra)
Hajj
N = 1433 (before Hajj)
N = 613 (post Hajj)
Hajj study
Before Umra 2008: 2.5 Before Umra 2008
Adults (18–100 y): 2.5
Before Umra 2008
All: 2.5
Post Umra 2008: 5.7 Post Umra 2008
Adults (18–100 y): 5.7
Post Umra 2008
All: 5.7
Before Umra 2008: 5.9 Before Umra 2008
Adults (18–100 y): 5.9
Before Umra 2008
All: 5.9
Post Hajj 2008: 11.1 Post Hajj 2008
Adults (18–100 y): 11.1
Post Hajj 2008
All: 11.1
Saudi Arabia [45] Cross-sectional study Hajj terminal of King Abdulaziz International Airport (Jeddah) Pilgrims
N = 2249 (post Hajj)
Hajj study
Post-Hajj 2017: 4.6 Children and adults (11–100 y): 4.6 All: 4.6
- A: 0.1
- B: 0.4
- C: 0.4
- W135: 0.1
- X: 0.3
- Y: 0.1
Turkey [46] Cross-sectional study Military unit (NR) Military
N = 1995
2008: 4.2 Adults (21–29 y): 4.2 All: 4.2
- A: 0.1
- B: 0.3
- C: 0.4
- W135: 0.5
- Y: 0.7
- Other: 2.3
Turkey [57] Longitudinal study Hacettepe University (Ankara) Pilgrims and household contacts
N = 472 (pilgrims before Hajj 2010)
N = 296 (pilgrims post Hajj 2010)
N = 39 (household contacts 2–3 months post Hajj 2010)
Hajj study
I. Pilgrims before Hajj 2010: 13.3 I. Children and adults (15–64 y): 13.3 I. All: 13.3
- A: 0.2
- B: 1.9
- W135: 11.0
- Y: 0.2
II. Pilgrims post Hajj 2010: 27.4 II. Children and adults (15–64 y): 27.4 II. All: 27.4
- A: 0.3
- B: 1.7
- W135: 25.0
- Y: 0.3
III. Household contacts post Hajj 2010: 25.6 Children and adults (NR): 25.6 All: 25.6
W135: 25.6
Adults (20–70 y): 2.5  
Turkey [122] Cohort study Esenboğa Airport (Ankara) Pilgrims
N = 229 (pre-Hajj, paired cohort)
N = 229 (post-Hajj, paired cohort)
Hajj study
I. Pre-Hajj 2018: 3.9 I. Children and adults (10–80 y): 3.9 I. All: 3.9
- B: 3.9
II. Post Hajj 2018: 0.4 II. Children and adults (10–80 y): 0.4 II. All: 0.4
- B: 0.4