Sex Difference in Meningococcal Disease Mortality, New York City, 2008-2016
| Autor: | Laura Miller, Sandhya Clark, Inessa Rubinstein, Kenya Murray, Stephanie Ngai, Arianne Ramautar, Ifeoma Ezeoke, Joseph Kennedy, Lola Arakaki, Eric C. Peterson, Paula Del Rosso, Megan Halbrook, Don Weiss, Sarah L. Braunstein, Tanya A. Halse, Mike Antwi, Danielle Bloch, Marie Dorsinville |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male Adolescent 030106 microbiology Neisseria meningitidis Meningococcal disease 03 medical and health sciences symbols.namesake Young Adult 0302 clinical medicine Sex Factors Risk Factors Case fatality rate Risk of mortality Medicine Humans 030212 general & internal medicine Poisson regression Aged Retrospective Studies Communicable disease business.industry Incidence Retrospective cohort study Middle Aged medicine.disease Confidence interval Meningococcal Infections Infectious Diseases Relative risk Epidemiological Monitoring symbols Regression Analysis Female New York City business Demography |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 67(5) |
| ISSN: | 1537-6591 |
| Popis: | Background The case fatality rate (CFR) from invasive meningococcal disease (IMD) in New York City (NYC) is greater than national figures, with higher rates among females than males across all age groups. Methods We conducted a retrospective cohort study among 151 persons aged ≥15 years diagnosed with IMD in NYC during 2008-2016 identified through communicable disease surveillance. We examined demographic, clinical, and community-level associations with death to confirm the elevated risk of mortality among female IMD patients after adjusting for confounders and to determine factors associated with female IMD mortality. Relative risks of death were estimated using multivariable log-linear Poisson regression with a robust error variance. Results Females had a higher CFR (n = 23/62; 37%) following IMD than males (n = 17/89; 19%) (adjusted relative risk [aRR], 2.1; 95% confidence interval [CI], 1.2-3.8). Controlling for demographic and clinical factors, there was a significant interaction between sex and fatal outcomes related to meningitis: the relative risk of death for females with meningitis was 13.7 (95% CI, 3.2-58.1) compared with males. In the model restricted to females, altered mental status (aRR, 7.5; 95% CI, 2.9-19.6) was significantly associated with an increased risk of death. Conclusions Female mortality from IMD was significantly increased compared with males, controlling for other predictors of mortality. Sex-based differences in recognition and treatment need to be evaluated in cases of meningococcal disease. Our study highlights the importance of analyzing routine surveillance data to identify and address disparities in disease incidence and outcomes. |
| Databáze: | OpenAIRE |
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