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Mortality in meningococcal disease in Belgium
Abstract:
A survey of children admitted with meningococcal disease to 53 paediatric units in Belgium between 1975 and 1979 was made in order to assess the case mortality rate (CMR) and to identify risk factors associated with death. A total of 309 cases (226 bacteriologically confirmed and 83 unconfirmed) was recorded. The overall CMR was 6.1 per cent. It was 4.4 for bacteriologically confirmed cases and 10.8 for unconfirmed cases. The CMR was higher for septicaemia without meningitis (22.2 per cent) than for meningitis with or without signs of septicaemia (3.4 per cent). The risk of death was not related to the sex or nationality of the patients. Age was a major determinant of the CMR, independently of the clinical picture. The highest risk of death was in children under one year of age. Poor socio-economic conditions were a significant risk factor. Failure to recognise the severity of the disease by some poorly educated mothers, and the admission of the patient to a hospital lacking adequate facilities for managing severely affected children, were the two significant causes of delay of adequate treatment.
Insights
Meningococcal disease in children had a 6.1% case mortality rate (CMR). Infants under one year and those from poor socio-economic backgrounds faced the highest risk of death from this infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Meningococcal disease remains a significant cause of childhood mortality.
- Understanding risk factors is crucial for improving outcomes in pediatric cases.
Purpose of the Study:
- To assess the case mortality rate (CMR) of meningococcal disease in Belgian children.
- To identify key risk factors associated with mortality in pediatric meningococcal disease.
Main Methods:
- A retrospective survey of 309 children admitted with meningococcal disease across 53 Belgian pediatric units (1975-1979).
- Analysis of case fatality data, differentiating between bacteriologically confirmed and unconfirmed cases, and clinical presentations (meningitis vs. septicemia).
Main Results:
- The overall CMR was 6.1%, with higher rates in unconfirmed (10.8%) versus confirmed (4.4%) cases.
- Septicemia without meningitis had a significantly higher CMR (22.2%) compared to meningitis (3.4%).
- Infants under one year and children from lower socio-economic backgrounds exhibited increased mortality risk. Delays in treatment due to maternal underestimation of severity or inadequate hospital facilities were noted.
Conclusions:
- Age (infants <1 year) and socio-economic status are critical determinants of mortality in pediatric meningococcal disease.
- Timely recognition of disease severity and access to appropriate pediatric intensive care facilities are vital for reducing fatalities.