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Longer term outcomes following serogroup B invasive meningococcal disease
Lucy Deng1,2, Belinda Barton2,3, Jennifer Lorenzo4
1National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Insights
Serogroup B invasive meningococcal disease (IMD) causes significant long-term physical and psychological problems in children. This burden has substantial economic implications for families and healthcare systems.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Serogroup B invasive meningococcal disease (IMD) is a serious infection in children.
- Long-term outcomes and associated burdens are not fully characterized.
Purpose of the Study:
- To characterize the physical, psychological, and quality of life burden of serogroup B IMD in children.
- To assess long-term sequelae and healthcare needs post-disease.
Main Methods:
- Retrospective study of children (up to 14 years) admitted to intensive care units for serogroup B IMD.
- Clinical and neuropsychological assessments conducted up to 6 years post-disease.
Main Results:
- Seven of eleven children experienced long-term physical disabilities.
- Complications included seizures, ataxia, hypermetropia, anxiety, speech delay, and lower IQ scores.
- Five children required ongoing medical and allied health care.
Conclusions:
- Serogroup B IMD leads to significant long-term morbidity and burden on children and families.
- The economic impact of IMD requires further quantification.
- Consideration of these burdens is crucial for vaccine cost-effectiveness analyses.
Aim:
To characterise the physical, psychological, and quality of life burden associated with serogroup B invasive meningococcal disease (IMD) in children.
Methods:
Children aged up to 14 years at the time of serogroup B IMD, who were admitted to intensive care units of two tertiary paediatric hospitals in New South Wales, Australia between January 2009 and December 2013 were recruited. Children underwent clinical and neuropsychological assessments up to 6 years post-disease.
Results:
Eleven children were assessed, with a median age of 16 months (range 4-46 months) at time of disease. The median follow-up time was 50 months (range 10-67 months). Seven (63.6%) cases had one or more long-term sequelae involving permanent and evolving physical disability. Three cases had ongoing medical conditions including two with seizures and one with ataxia and hypermetropia. Five required ongoing medical and allied health care. Other complications identified included anxiety, speech delay, low average full-scale IQ score (median 85, interquartile range 89-103) and borderline memory impairment.
Conclusions:
Serogroup B IMD is associated with significant long-term morbidity and burden on the child and family with substantial economic implications. The impact of this on the total cost of IMD needs to be further quantified, and better considered in vaccine cost-effectiveness analyses.
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