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Invasive meningococcal disease in England: assessing disease burden through linkage of multiple national data sources

Shamez N Ladhani1, Pauline A Waight2, Sonia Ribeiro3

  • 1Immunisation, Hepatitis and Blood Safety Department, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK. shamez.ladhani@phe.gov.uk.

BMC Infectious Diseases
|December 3, 2015
PubMed
Abstract

Insights

Public Health England

Area of Science:

  • Infectious Disease Epidemiology
  • Public Health Surveillance

Background:

  • Public Health England (PHE) performs enhanced surveillance of invasive meningococcal disease (IMD).
  • A decline in reported IMD cases raises concerns about underestimation of true incidence by the Meningococcal Reference Unit (MRU).

Purpose of the Study:

  • To estimate the true burden of invasive meningococcal disease (IMD) in England.
  • To assess the accuracy of current IMD surveillance methods by linking national datasets.

Main Methods:

  • Linked five national datasets: MRU confirmations, Hospital Episode Statistics (HES), NHS electronic reports, death registrations, and private laboratory reports.
  • Analyzed data from 2007-2011 to compare MRU-confirmed IMD cases with hospital records and laboratory results.

Main Results:

  • MRU confirmed 5115 IMD cases; 84% matched HES records.
  • An additional 2792 hospitalised cases with suspected IMD (ICD-10 code A39*) were found in HES.
  • Of these, 52% had negative PCR tests for IMD, and few had other laboratory confirmations, suggesting over-diagnosis or misclassification.

Conclusions:

  • Linking multiple data sources revealed few additional IMD confirmations beyond MRU data.
  • A high number of unconfirmed or PCR-negative suspected IMD cases in HES indicates increased clinical awareness and potentially lower hospitalisation thresholds.

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