Meningococcal Disease in Children in Argentina A 3-year Active Sentinel Hospital Surveillance Study
| Autor: | Andrea Gajo Gane, Ricardo Rüttimann, Mabel Regueira, Alejandro Santillán Iturres, Julia Bakir, Gabriela Ensinck, Angela Gentile, Hector Abate, María Rosa Agosti, Adriana M. Efron |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty Adolescent 030106 microbiology MEDLINE Argentina Meningococcal vaccine Neisseria meningitidis medicine.disease_cause Meningococcal disease Serogroup 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Humans 030212 general & internal medicine Prospective Studies Intensive care medicine Prospective cohort study Child business.industry Public health Incidence (epidemiology) Infant Newborn Infant medicine.disease Meningococcal Infections Infectious Diseases Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Female business Sentinel Surveillance |
| Zdroj: | The Pediatric infectious disease journal. 36(3) |
| ISSN: | 1532-0987 |
| Popis: | Meningococcal disease (MD) is a medical emergency and a serious public health problem. As new meningococcal vaccines become available, MD surveillance is crucial to provide baseline epidemiologic data before implementing preventive measures. We estimated MD incidence and epidemiology in Argentina using hospital-based surveillance.Three-year prospective active surveillance in patients ≤15 years of age was conducted at 6 pediatric hospital sentinel units (March 2012 to February 2015).Of 184,360 hospitalized patients, 1444 (0.78%) had suspected meningitis or MD. Of these, 268 (19%) presented probable acute bacterial meningitis or MD, 168 (63%) were culture positive and 51 (30%) tested positive for Neisseria meningitidis. Of 100 culture-negative cases, 30 had positive meningococcal polymerase chain reaction. Thirteen patients presented other uncommon MD manifestations, resulting in a total of 94 MD cases and an annual incidence of 5.1/10 hospitalized patients [95% confidence interval (CI): 4-6]. Fifty-four (57%) patients were males, 48% were1 year of age and the median age was 12.5 months (1 month to 15 years). Clinical presentations were the following: meningococcemia and meningitis (37%), meningitis (30%), meningococcemia (16%), arthritis (10%), bacteremia (5%) and pneumonia (2%). Twenty-eight percent had complications. Nine children died (case fatality rate: 10%), and 8 had sequelae. Serogroups were identified for 84 isolates. Serogroup W was associated with age1 year (odds ratio: 3.18; 95% CI: 1.14-8.99); meningococcemia was associated with mortality (P = 0.0038).Highest rates of MD were observed among young infants. This study provides baseline data to estimate the impact of introducing meningococcal vaccines in Argentina. |
| Databáze: | OpenAIRE |
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