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Risk factors for death from meningococcal infection in Recife, Brazil

Maria C M B Duarte1, Melânia R Amorim, Luis E Cuevas

  • 1Instituto Materno Infantil de Pernambuco, Recife, Brazil. mestrado@imip.org.br

Journal of Tropical Pediatrics
|July 8, 2005
PubMed

Insights

Invasive meningococcal infection is deadly in Brazilian children, particularly septic forms. Early symptom onset, low platelets, and acidosis significantly increase death risk.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Invasive meningococcal infection (IMI) poses a significant threat to child health globally.
  • Understanding case fatality rates and risk factors is crucial for improving outcomes, especially in middle-income countries.

Purpose of the Study:

  • To determine the case fatality rate (CFR) of invasive meningococcal infection in children.
  • To identify significant risk factors associated with mortality in pediatric cases of meningococcal disease.

Main Methods:

  • Retrospective cohort study of 163 children admitted with meningococcal disease to a tertiary pediatric hospital in Recife, Brazil.
  • Cases were categorized into meningitis, septicemia, and combined septicemia with meningitis.
  • Statistical analysis was performed to identify risk factors for death, including symptom duration, platelet count, and acidosis.

Main Results:

  • The overall case fatality rate was high, with significant variations across disease presentations.
  • Children with septicemia alone had the highest CFR (62.1%), followed by those with septicemia and meningitis (35.2%), and meningitis alone (8.7%).
  • Significant risk factors for death included symptom onset <24 hours (AOR 3.8), platelet count <100,000/mm³ (AOR 13.8), and acidosis (AOR 6.0).

Conclusions:

  • Invasive meningococcal infection, especially its septic forms, has a high case fatality rate in this Brazilian tertiary center.
  • Identifying risk factors like rapid symptom progression, thrombocytopenia, and acidosis can aid in early recognition and management of high-risk pediatric patients.
  • These findings are vital for resource-limited settings to improve clinical decision-making and reduce mortality from meningococcal disease.

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