Meningococcal Disease in Children in Merseyside, England: A 31 Year Descriptive Study

Michelle C Stanton, David Taylor-Robinson, David Harris, Fauzia Paize, Nick Makwana, Scott J Hackett, Paul B Baines, F Andrew I Riordan, Omnia Marzouk, Alistair P J Thomson, Peter J Diggle, C Anthony Hart and Enitan D Carrol

PLOS ONE, 2011, vol. 6, issue 10, 1-7

Abstract: 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.

Date: 2011
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0025957

DOI: 10.1371/journal.pone.0025957

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