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Outcomes after meningococcal disease remain poor in Canada
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Adults and children in Canada continue to experience poor outcomes from invasive meningococcal disease, with 27% of cases leading to death or significant complications, according to recent findings published in Clinical Infectious Diseases.
Manish Sadarangani, DPhil, of Oxford University, and colleagues conducted a prospective cohort study using surveillance data on 868 Canadian children and adults with invasive meningococcal disease (IMD) collected by the Canadian Immunization Monitoring Program, ACTive (IMPACT), between 2002 and 2011.
The researchers assessed risk factors associated with IMD-related death and complications. They found that adults experienced a higher case-fatality rate than children (12% vs. 4.1%), but more children had at least one complication (21% vs. 15%). Of the entire cohort, 8.4% died and 18% developed complications.
The most prevalent complications including hearing loss (5.4%), skin scarring (5.4%), amputation (3.4%), renal dysfunction (2.6%) and seizures (2.5%). Independent associations were seen between death and shock (adjusted OR = 23.3; P < .0001), age (aOR = 1.02 per 1-year increased age; P < .0001), and onset of symptoms within 24 hours of admission (aOR = 1.8; P = .0471). Admission to the ICU was related to decreased mortality (aOR = 0.41; P = .0196), according to the researchers.
The onset of complications from IMD was correlated with seizures (aOR = 4.55; P < .0001), shock (aOR = 3.1; P < .0001), abnormal platelet count (aOR = 2.14; P = .0002), bruising (aOR = 3.17; P = .0059), abnormal white blood cell count (aOR = 0.52; P = .01), and previous antibiotic exposure (aOR = 0.27; P = .0273).
According to the researchers, it is likely that the significant burden of IMD will only be diminished through effective meningococcal vaccination against all capsular groups.
“These vaccines will result in further reductions in disease, although this will be dependent upon achieving high population coverage and, in the case of group B vaccines, broad protection against different strains,” the researchers wrote. – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
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