N. E. Rosenstein, B. A. Perkins, D. S. Stephens, T. Popovic, and J. M. Hughes, Meningococcal 360 disease, N Engl J Med, vol.344, pp.1378-1388, 2001.

L. H. Harrison, S. I. Pelton, A. Wilder-smith, J. Holst, M. A. Safadi et al., , p.362

F. M. Laforce, A. Von-gottberg, R. Borrow, and S. A. Plotkin, The Global, vol.363, 2011.

, Meningococcal Initiative: recommendations for reducing the global burden of 364 meningococcal disease, Vaccine, vol.29, pp.3363-3371

L. H. Harrison, C. L. Trotter, and M. E. Ramsay, Global epidemiology of meningococcal 366 disease, Vaccine, vol.27, pp.51-63, 2009.

M. O'ryan, J. Stoddard, D. Toneatto, J. Wassil, and P. M. Dull, A multi-component 368 meningococcal serogroup B vaccine (4CMenB): the clinical development program, 2014.

, Drugs, vol.74, pp.15-30

E. Hong, M. M. Giuliani, A. E. Deghmane, M. Comanducci, B. Brunelli et al., Taha 371 MK. 2013. Could the multicomponent meningococcal serogroup B vaccine (4CMenB, p.372

, control Neisseria meningitidis capsular group X outbreaks in Africa? Vaccine, vol.31, pp.1113-373

C. E. Frasch, M. P. Preziosi, and F. M. Laforce, Development of a group A meningococcal 375 conjugate vaccine, MenAfriVac(TM), Hum Vaccin Immunother, vol.8, pp.715-724, 2012.

P. Boisier, P. Nicolas, S. Djibo, M. K. Taha, J. I. Mainassara et al., Meningococcal meningitis: unprecedented 378 incidence of serogroup X-related cases in 2006 in Niger, Clin Infect Dis, vol.44, pp.657-663, 2007.

M. K. Taha, I. Parent-du-chatelet, M. Schlumberger, I. Sanou, S. Djibo et al., , p.380

J. M. Alonso, Neisseria meningitidis serogroups W135 and A were equally prevalent, vol.381, p.17, 2002.

, among meningitis cases occurring at the end of the 2001 epidemics in Burkina Faso and 382

. Niger, J Clin Microbiol, vol.40, pp.1083-1084

J. M. Collard, B. Issaka, M. Zaneidou, S. Hugonnet, P. Nicolas et al., , vol.384

J. F. Jusot, Epidemiological changes in meningococcal meningitis in Niger from 385 2008 to 2011 and the impact of vaccination, BMC Infect Dis, vol.13, p.576, 2013.

A. Terrade, J. M. Collard, F. Nato, and M. K. Taha, Laboratory evaluation of a rapid 387 diagnostic test for Neisseria meningitidis serogroup A, Trans R Soc Trop Med Hyg, 2013.

S. Chanteau, F. Sidikou, S. Djibo, A. Moussa, H. Mindadou et al., Scaling up of 389 PCR-based surveillance of bacterial meningitis in the African meningitis belt: 390 indisputable benefits of multiplex PCR assay in Niger, Trans R Soc Trop Med Hyg, vol.100, pp.391-677, 2006.

S. Chanteau, S. Dartevelle, A. E. Mahamane, S. Djibo, P. Boisier et al., New rapid 393 diagnostic tests for Neisseria meningitidis serogroups A, W135, C, and Y, PLoS Med, vol.3, p.337, 2006.

, Reporting on 2010 surveillance data and 2011 epidemic intelligence data, vol.397, 2012.

F. Micoli, M. R. Romano, M. Tontini, E. Cappelletti, M. Gavini et al., , p.399

E. Swennen, L. Santini, S. Filippini, C. Balocchi, R. Adamo et al.,

A. Pollard, A. Saul, R. Rappuoli, C. A. Maclennan, F. Berti et al., , 2013.

, Development of a glycoconjugate vaccine to prevent meningitis in Africa caused by 402 meningococcal serogroup X, Proc Natl Acad Sci, vol.110, pp.19077-19082

D. S. Kellogg, W. L. Peacock, J. Deacon, W. E. Brown, L. Pirkle et al., Neisseria 404 gonorrhoeae. I. Virulence Genetically Linked to Clonal Variation, J Bacteriol, vol.85, pp.1274-405, 1963.

T. L. Ballard, M. H. Roe, R. C. Wheeler, J. K. Todd, and M. P. Glode, Comparison of three latex 407 agglutination kits and counterimmunoelectrophoresis for the detection of bacterial 408 antigens in a pediatric population, Pediatr Infect Dis J, vol.6, pp.630-634, 1987.

H. Abdillahi and J. T. Poolman, Neisseria meningitidis group B serosubtyping using 410 monoclonal antibodies in whole-cell ELISA, Microb Pathog, vol.4, pp.27-32, 1988.

I. Du-chatelet, Y. Traore, B. D. Gessner, A. Antignac, and B. Naccro, , p.412

B. M. Lafourcade, M. S. Ouedraogo, S. R. Tiendrebeogo, E. Varon, and M. K. Taha, , 2005.

, Bacterial meningitis in Burkina Faso: surveillance using field-based polymerase chain 414 reaction testing, Clin Infect Dis, vol.40, pp.17-25

F. Nato, J. C. Mazie, J. M. Fournier, B. Slizewicz, N. Sagot et al., Riou 416 JY. 1991. Production of polyclonal and monoclonal antibodies against group A, B, and C 417 capsular polysaccharides of Neisseria meningitidis and preparation of latex reagents, J 418 Clin Microbiol, vol.29, pp.1447-1452

O. Xie, B. Bolgiano, F. Gao, K. Lockyer, C. Swann et al., , p.420

B. M. Lafourcade, T. A. Tamekloe, A. J. Pollard, and G. Norheim, Characterization of 421 size, structure and purity of serogroup X Neisseria meningitidis polysaccharide, and 422 development of an assay for quantification of human antibodies, Vaccine, vol.30, pp.5812-5823, 2012.

M. K. Taha and D. Giorgini, Phosphorylation and functional analysis of PilA, a protein 424 involved in the transcriptional regulation of the pilin gene in Neisseria gonorrhoeae, Mol 425 Microbiol, vol.15, pp.667-677, 1995.

S. Chanteau, L. Rahalison, L. Ralafiarisoa, J. Foulon, and M. Ratsitorahina, , p.427

L. , C. E. Nato, and F. , Development and testing of a rapid diagnostic test for 428 bubonic and pneumonic plague, Lancet, vol.361, pp.211-216, 2003.

R. Jaeschke, G. H. Guyatt, and D. L. Sackett, Users' guides to the medical literature. III. How 430 to use an article about a diagnostic test. B. What are the results and will they help me in 431 caring for my patients? The Evidence-Based Medicine Working Group, JAMA, vol.271, pp.432-703, 1994.

A. S. Glas, J. G. Lijmer, M. H. Prins, G. J. Bonsel, and P. M. Bossuyt, The diagnostic odds ratio: 434 a single indicator of test performance, J Clin Epidemiol, vol.56, pp.1129-1135, 2003.

J. Cohen, A coefficient of agreement for nominal scales, Edu Psychol Measur, vol.20, pp.37-436, 1960.

K. A. Cartwright, S. Reilly, D. White, and J. Stuart, Early treatment with parenteral 438 penicillin in meningococcal disease, Bmj, vol.305, pp.143-147, 1992.

, Table 1. Strains used in the study and their characteristics 450 Strain reference Serogroup:serotype/serosub-type 21525* A:4:P1.9 21526 A:4:P1.9 19256 B:NT:P1.5,2 19257 B:2a:P1.5, vol.5