Abstract
Introduction: Upper respiratory tract carriage of Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) is a key precursor to each pathogen causing invasive disease and plays a central role in transmission within households and communities. Pacific populations in New Zealand experience a disproportionate burden of invasive bacterial disease, however, current data on carriage patterns within Pacific households remain limited.
Aim: The study aimed to determine the prevalence and determinants of pneumococcal and meningococcal carriage in Pacific households in South Auckland, providing baseline data to inform public health policy.
Methods: The study investigated pneumococcal and meningococcal carriage among Pacific households using a community-based, cross-sectional study design. Participants were recruited through a combination of random household sampling and community outreach. Nasopharyngeal and oropharyngeal swabs were collected and analysed using molecular methods to detect bacterial carriage. Demographic, household, behavioural, and medical data were collected through structured questionnaires. Statistical analyses were conducted to estimate carriage prevalence and univariable and multivariable logistic regression analyses to explore association with age, individual-level, and household-level characteristics.
Results: Pneumococcal carriage (34.3%) was common within Pacific households, with the highest prevalence observed among children aged 1−4 years (57.5%). After adjustment, pneumococcal carriage was strongly associated with young age, particularly among children aged 1−4 years (aOR 8.4, 95% CI 3.8, 18.5), and with sharing a bed with a child (aOR 1.8, 95% CI 1.1, 2.9). Meningococcal carriage (17.3%) was detected across age groups but was more frequently observed among adolescents and young adults aged 15−24-years (25.4%); in adjusted analyses, carriage in this age group was associated with higher odds (aOR 2.9, 95% CI 1.2, 6.6), as well as with recent social mixing (aOR 8.4, 95% CI 1.0, 4.1) and sharing a bed with a child (aOR 1.8, 95% CI 1.0, 3.4).
Conclusion: This study provides baseline data on pneumococcal and meningococcal carriage within Pacific households and demonstrates that carriage is independently associated with age and close-contact household behaviours. Pneumococcal carriage was strongly associated with young age, particularly children aged 1−4 years, while meningococcal carriage was highest among adolescents and young adults aged 15−24 years and was associated with social mixing. Sharing a bed with a child was independently associated with carriage of both pathogens. These findings underscore the importance of culturally grounded, household-based, Pacific-led surveillance to inform equitable public health interventions and vaccination strategies.