B Part of It protocol: A cluster randomised controlled trial to assess the impact of 4CMenB vaccine on pharyngeal carriage of Neisseria meningitidis in adolescents

Helen S. Marshall, Mark McMillan, Ann Koehler, Andrew Lawrence, Jenny M. Maclennan, Martin C.J. Maiden, Mary Ramsay, Shamez N. Ladhani, Caroline Trotter, Ray Borrow, Adam Finn, Thomas Sullivan, Peter Richmond, Charlene M. Kahler, Jane Whelan, Kumaran Vadivelu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction South Australia (SA) has the highest notification rate of invasive meningococcal disease in Australia with the majority of cases due to serogroup B. Neisseria meningitidis is carried in the pharynx, with adolescents having the highest rates of carriage. A vaccine designed to offer protection against serogroup B (4CMenB) is licensed in Australia. The SA MenB vaccine carriage study aims to assess the impact of 4CMenB on carriage of N. meningitidis in adolescents. Methods and analysis This is a parallel cluster randomised controlled trial enrolling year 10, 11 and 12 school students (approximately 16-18 years of age) throughout SA, in metropolitan and rural/remote areas. Schools are randomised to intervention (4CMenB vaccination at baseline) or control (4CMenB vaccination at study completion) with randomisation stratified by school size and socioeconomic status, as measured by the Index of Community Socio-Educational Advantage (Australian Curriculum). Oropharyngeal swabs will be taken from all students at visit 1, and 12 months later from year 11 and 12 students. Students unvaccinated in 2017 will receive vaccine at the 12-month follow-up. Carriage prevalence of N. meningitidis will be determined by PCR at baseline and 12 months following 4CMenB vaccination and compared with carriage prevalence at 12 months in unvaccinated students. A questionnaire will be completed at baseline and 12 months to assess risk factors associated with carriage. The primary outcome of carriage prevalence of disease causing N. meningitidis at 12 months will be compared between groups using logistic regression, with generalised estimating equations used to account for clustering at the school level. The difference in carriage prevalence between groups will be expressed as an OR with 95% CI. Ethics and dissemination The study was approved by the Women's and Children's Health Network Human Research Ethics Committee (WCHN HREC). The protocol, informed consent forms, recruitment materials, social media and all participant materials have been reviewed and approved by the WCHN HREC and updated on ClinicalTrials.gov. Results will be published in international peer-reviewed journals and presented at national and international conferences. The study findings will be provided in public forums and to study participants and participating schools. Trial registration number ACTRN12617000079347. NCT03089086; Pre-results.

LanguageEnglish
Article numbere020988
JournalBMJ open
Volume8
Issue number7
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • carriage
  • epidemiology
  • meningococcal disease
  • public health
  • randomised controlled trial

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Marshall, Helen S. ; McMillan, Mark ; Koehler, Ann ; Lawrence, Andrew ; Maclennan, Jenny M. ; Maiden, Martin C.J. ; Ramsay, Mary ; Ladhani, Shamez N. ; Trotter, Caroline ; Borrow, Ray ; Finn, Adam ; Sullivan, Thomas ; Richmond, Peter ; Kahler, Charlene M. ; Whelan, Jane ; Vadivelu, Kumaran. / B Part of It protocol : A cluster randomised controlled trial to assess the impact of 4CMenB vaccine on pharyngeal carriage of Neisseria meningitidis in adolescents. In: BMJ open. 2018 ; Vol. 8, No. 7.
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abstract = "Introduction South Australia (SA) has the highest notification rate of invasive meningococcal disease in Australia with the majority of cases due to serogroup B. Neisseria meningitidis is carried in the pharynx, with adolescents having the highest rates of carriage. A vaccine designed to offer protection against serogroup B (4CMenB) is licensed in Australia. The SA MenB vaccine carriage study aims to assess the impact of 4CMenB on carriage of N. meningitidis in adolescents. Methods and analysis This is a parallel cluster randomised controlled trial enrolling year 10, 11 and 12 school students (approximately 16-18 years of age) throughout SA, in metropolitan and rural/remote areas. Schools are randomised to intervention (4CMenB vaccination at baseline) or control (4CMenB vaccination at study completion) with randomisation stratified by school size and socioeconomic status, as measured by the Index of Community Socio-Educational Advantage (Australian Curriculum). Oropharyngeal swabs will be taken from all students at visit 1, and 12 months later from year 11 and 12 students. Students unvaccinated in 2017 will receive vaccine at the 12-month follow-up. Carriage prevalence of N. meningitidis will be determined by PCR at baseline and 12 months following 4CMenB vaccination and compared with carriage prevalence at 12 months in unvaccinated students. A questionnaire will be completed at baseline and 12 months to assess risk factors associated with carriage. The primary outcome of carriage prevalence of disease causing N. meningitidis at 12 months will be compared between groups using logistic regression, with generalised estimating equations used to account for clustering at the school level. The difference in carriage prevalence between groups will be expressed as an OR with 95{\%} CI. Ethics and dissemination The study was approved by the Women's and Children's Health Network Human Research Ethics Committee (WCHN HREC). The protocol, informed consent forms, recruitment materials, social media and all participant materials have been reviewed and approved by the WCHN HREC and updated on ClinicalTrials.gov. Results will be published in international peer-reviewed journals and presented at national and international conferences. The study findings will be provided in public forums and to study participants and participating schools. Trial registration number ACTRN12617000079347. NCT03089086; Pre-results.",
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Marshall, HS, McMillan, M, Koehler, A, Lawrence, A, Maclennan, JM, Maiden, MCJ, Ramsay, M, Ladhani, SN, Trotter, C, Borrow, R, Finn, A, Sullivan, T, Richmond, P, Kahler, CM, Whelan, J & Vadivelu, K 2018, 'B Part of It protocol: A cluster randomised controlled trial to assess the impact of 4CMenB vaccine on pharyngeal carriage of Neisseria meningitidis in adolescents', BMJ open, vol. 8, no. 7, e020988. https://doi.org/10.1136/bmjopen-2017-020988

B Part of It protocol : A cluster randomised controlled trial to assess the impact of 4CMenB vaccine on pharyngeal carriage of Neisseria meningitidis in adolescents. / Marshall, Helen S.; McMillan, Mark; Koehler, Ann; Lawrence, Andrew; Maclennan, Jenny M.; Maiden, Martin C.J.; Ramsay, Mary; Ladhani, Shamez N.; Trotter, Caroline; Borrow, Ray; Finn, Adam; Sullivan, Thomas; Richmond, Peter; Kahler, Charlene M.; Whelan, Jane; Vadivelu, Kumaran.

In: BMJ open, Vol. 8, No. 7, e020988, 01.07.2018.

Research output: Contribution to journalArticle

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T1 - B Part of It protocol

T2 - BMJ Open

AU - Marshall, Helen S.

AU - McMillan, Mark

AU - Koehler, Ann

AU - Lawrence, Andrew

AU - Maclennan, Jenny M.

AU - Maiden, Martin C.J.

AU - Ramsay, Mary

AU - Ladhani, Shamez N.

AU - Trotter, Caroline

AU - Borrow, Ray

AU - Finn, Adam

AU - Sullivan, Thomas

AU - Richmond, Peter

AU - Kahler, Charlene M.

AU - Whelan, Jane

AU - Vadivelu, Kumaran

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Introduction South Australia (SA) has the highest notification rate of invasive meningococcal disease in Australia with the majority of cases due to serogroup B. Neisseria meningitidis is carried in the pharynx, with adolescents having the highest rates of carriage. A vaccine designed to offer protection against serogroup B (4CMenB) is licensed in Australia. The SA MenB vaccine carriage study aims to assess the impact of 4CMenB on carriage of N. meningitidis in adolescents. Methods and analysis This is a parallel cluster randomised controlled trial enrolling year 10, 11 and 12 school students (approximately 16-18 years of age) throughout SA, in metropolitan and rural/remote areas. Schools are randomised to intervention (4CMenB vaccination at baseline) or control (4CMenB vaccination at study completion) with randomisation stratified by school size and socioeconomic status, as measured by the Index of Community Socio-Educational Advantage (Australian Curriculum). Oropharyngeal swabs will be taken from all students at visit 1, and 12 months later from year 11 and 12 students. Students unvaccinated in 2017 will receive vaccine at the 12-month follow-up. Carriage prevalence of N. meningitidis will be determined by PCR at baseline and 12 months following 4CMenB vaccination and compared with carriage prevalence at 12 months in unvaccinated students. A questionnaire will be completed at baseline and 12 months to assess risk factors associated with carriage. The primary outcome of carriage prevalence of disease causing N. meningitidis at 12 months will be compared between groups using logistic regression, with generalised estimating equations used to account for clustering at the school level. The difference in carriage prevalence between groups will be expressed as an OR with 95% CI. Ethics and dissemination The study was approved by the Women's and Children's Health Network Human Research Ethics Committee (WCHN HREC). The protocol, informed consent forms, recruitment materials, social media and all participant materials have been reviewed and approved by the WCHN HREC and updated on ClinicalTrials.gov. Results will be published in international peer-reviewed journals and presented at national and international conferences. The study findings will be provided in public forums and to study participants and participating schools. Trial registration number ACTRN12617000079347. NCT03089086; Pre-results.

AB - Introduction South Australia (SA) has the highest notification rate of invasive meningococcal disease in Australia with the majority of cases due to serogroup B. Neisseria meningitidis is carried in the pharynx, with adolescents having the highest rates of carriage. A vaccine designed to offer protection against serogroup B (4CMenB) is licensed in Australia. The SA MenB vaccine carriage study aims to assess the impact of 4CMenB on carriage of N. meningitidis in adolescents. Methods and analysis This is a parallel cluster randomised controlled trial enrolling year 10, 11 and 12 school students (approximately 16-18 years of age) throughout SA, in metropolitan and rural/remote areas. Schools are randomised to intervention (4CMenB vaccination at baseline) or control (4CMenB vaccination at study completion) with randomisation stratified by school size and socioeconomic status, as measured by the Index of Community Socio-Educational Advantage (Australian Curriculum). Oropharyngeal swabs will be taken from all students at visit 1, and 12 months later from year 11 and 12 students. Students unvaccinated in 2017 will receive vaccine at the 12-month follow-up. Carriage prevalence of N. meningitidis will be determined by PCR at baseline and 12 months following 4CMenB vaccination and compared with carriage prevalence at 12 months in unvaccinated students. A questionnaire will be completed at baseline and 12 months to assess risk factors associated with carriage. The primary outcome of carriage prevalence of disease causing N. meningitidis at 12 months will be compared between groups using logistic regression, with generalised estimating equations used to account for clustering at the school level. The difference in carriage prevalence between groups will be expressed as an OR with 95% CI. Ethics and dissemination The study was approved by the Women's and Children's Health Network Human Research Ethics Committee (WCHN HREC). The protocol, informed consent forms, recruitment materials, social media and all participant materials have been reviewed and approved by the WCHN HREC and updated on ClinicalTrials.gov. Results will be published in international peer-reviewed journals and presented at national and international conferences. The study findings will be provided in public forums and to study participants and participating schools. Trial registration number ACTRN12617000079347. NCT03089086; Pre-results.

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KW - epidemiology

KW - meningococcal disease

KW - public health

KW - randomised controlled trial

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