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, Enitan D. Carrol

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article numbere25957
JournalPLoS One
Volume6
Issue number10
DOIs
StatePublished - Oct 7 2011
Externally publishedYes

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descriptive studies
septicemia
England
meningitis
Meningococcal Meningitis
Sepsis
serotypes
Alnus
risk factors
socioeconomic status
childhood
odds ratio
United Kingdom
epidemiology
public health
Health Priorities
demographic statistics
Epidemiology
Mortality
vaccines

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Stanton, M. C., Taylor-Robinson, D., Harris, D., Paize, F., Makwana, N., Hackett, S. J., ... Carrol, E. D. (2011). Meningococcal disease in children in Merseyside, england: A 31 year descriptive study. PLoS One, 6(10), [e25957]. https://doi.org/10.1371/journal.pone.0025957

Meningococcal disease in children in Merseyside, england : A 31 year descriptive study. / Stanton, Michelle C.; Taylor-Robinson, David; Harris, David; Paize, Fauzia; Makwana, Nick; Hackett, Scott J.; Baines, Paul B.; Riordan, F. Andrew I; Marzouk, Omnia; Thomson, Alistair P J; Diggle, Peter J.; Hart, C. Anthony; Carrol, Enitan D.

In: PLoS One, Vol. 6, No. 10, e25957, 07.10.2011.

Research output: Contribution to journalArticle

Stanton, MC, Taylor-Robinson, D, Harris, D, Paize, F, Makwana, N, Hackett, SJ, Baines, PB, Riordan, FAI, Marzouk, O, Thomson, APJ, Diggle, PJ, Hart, CA & Carrol, ED 2011, 'Meningococcal disease in children in Merseyside, england: A 31 year descriptive study', PLoS One, vol. 6, no. 10, e25957. https://doi.org/10.1371/journal.pone.0025957
Stanton MC, Taylor-Robinson D, Harris D, Paize F, Makwana N, Hackett SJ et al. Meningococcal disease in children in Merseyside, england: A 31 year descriptive study. PLoS One. 2011 Oct 7;6(10). e25957. https://doi.org/10.1371/journal.pone.0025957
Stanton, Michelle C. ; Taylor-Robinson, David ; Harris, David ; Paize, Fauzia ; Makwana, Nick ; Hackett, Scott J. ; Baines, Paul B. ; Riordan, F. Andrew I ; Marzouk, Omnia ; Thomson, Alistair P J ; Diggle, Peter J. ; Hart, C. Anthony ; Carrol, Enitan D. / Meningococcal disease in children in Merseyside, england : A 31 year descriptive study. In: PLoS One. 2011 ; Vol. 6, No. 10.
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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.",
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