Meningococcal disease in children in Merseyside, England : a 31 year descriptive study

Stanton, Michelle C. and Taylor-Robinson, David and Harris, David and Paize, Fauzia and Makwana, Nick and Hackett, Scott J. and Baines, Paul B. and Riordan, F. Andrew I. and Marzouk, Omnia and Thomson, Alistair P. J. and Diggle, Peter J. and Hart, C. Anthony and Carrol, Enitan D. (2011) Meningococcal disease in children in Merseyside, England : a 31 year descriptive study. PLoS ONE, 6 (10): e25957. -.

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Meningococcal disease (MCD) is the leading infectious cause of death in early childhood in the United Kingdom, making it a public health priority. MCD most commonly presents as meningococcal meningitis (MM), septicaemia (MS), or as a combination of the two syndromes (MM/MS). We describe the changing epidemiology and clinical presentation of MCD, and explore associations with socioeconomic status and other risk factors. A hospital-based study of children admitted to a tertiary children's centre, Alder Hey Children's Foundation Trust, with MCD, was undertaken between 1977 to 2007 (n = 1157). Demographics, clinical presentations, microbiological confirmation and measures of deprivation were described. The majority of cases occurred in the 1-4 year age group and there was a dramatic fall in serogroup C cases observed with the introduction of the meningococcal C conjugate (MCC) vaccine. The proportion of MS cases increased over the study period, from 11% in the first quarter to 35% in the final quarter. Presentation with MS (compared to MM) and serogroup C disease (compared to serogroup B) were demonstrated to be independent risk factors for mortality, with odds ratios of 3.5 (95% CI 1.18 to 10.08) and 2.18 (95% CI 1.26 to 3.80) respectively. Cases admitted to Alder Hey were from a relatively more deprived population (mean Townsend score 1.25, 95% CI 1.09 to 1.41) than the Merseyside reference population. Our findings represent one of the largest single-centre studies of MCD. The presentation of MS is confirmed to be a risk factor of mortality from MCD. Our study supports the association between social deprivation and MCD.

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© 2011 Stanton et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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?? mortalitydeprivationconfirmationepidemiologyhealth information, computation and statisticsgeneral agricultural and biological sciencesgeneral biochemistry,genetics and molecular biologygeneral medicineagricultural and biological sciences(all)biochemistry, ??
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08 Dec 2011 11:38
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16 Jul 2024 08:59