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Exact(7)
This finding was based on the relative rarity of double (or multiple) carriage in comparison with the point prevalence of individual serotypes in the study population.
The high multiple carriage in Malawian children provides opportunities for genetic exchange through horizontal gene transfer.
Yet despite its importance in pneumococcal evolution, evidence of multiple carriage in Africa has not been well documented.
It is therefore important to understand the dynamics of multiple carriage in a given setting in order to control pneumococcal spread and disease.
To our knowledge, this is the first study to report such pneumococcal serotype diversity and rates of multiple carriage in Malawian children.
Although pneumococcal carriage rates have been shown to decrease with age [ 40], this study could not establish the association between age and the prevalence of multiple carriage in children and further studies are therefore recommended.
Similar(53)
Since conventional serotyping methods are biased towards detection of the most abundant serotype, the VTs present at low abundance in multiple carriage events may not have been detected in these samples, which could have resulted in poor estimation of the vaccine coverage.
Because of the limited sample size, we were not able to characterise serotype-specific associations in multiple carriage.
There was no statistically significant difference in multiple carriage between younger and older children (48%%, 27/56 vs 32%%, 19/60, p = 0.08).
In those multiple carriage events, 61%% (28/46) co-carried at least one VT and an NVT, 15%% (7/46) carried VT only and 24%% (11/46) carried NVT only.
However, only one or two of the nine loci show >1 allele in many samples, suggesting that mutation within infections may result in overestimation of true multiple carriage rates.
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