Abstract
We estimated the long-term socioeconomic consequences and health care costs of Neisseria meningitidis meningitis (NM). The prospective cohort study included Danish individuals with onset of NM in childhood and adolescence, diagnosed between 1980 and 2009. Health care costs and socioeconomic data were obtained from nationwide administrative and health registers. Two thousand nine hundred two patients were compared with 11,610 controls matched for age, gender, and other sociodemographic characteristics. In the follow-up analysis at the age of 30 years, 1028 patients were compared with 4452 controls. We found that (1) NM caused increased mortality at disease onset, but after adequate treatment, the mortality rate was similar to that of the general population; (2) neurological and eye diseases were more frequently observed in patients; (3) patients had significantly lower grade-point averages; (4) patients had lower income even when transfer payments were taken into account; and (5) patients’ initial health care costs were elevated.
Conclusion: NM has significant influence on mortality, morbidity, education, and income. We suggest that the management of patients with previous meningococcal meningitis should focus on early educational and social interventions to improve social and health outcomes.
What is known: • Meningococcal meningitis is a severe infectious disease affecting children and adolescents with high rates of mortality and complications. | |
What is new: • Meningococcal meningitis causes increased mortality at disease onset, but after adequate treatment the mortality rate is similar to that of the general population. • Meningococcal meningitis in childhood and adolescence has a major long-term effect on morbidity, health care costs, education, employment, and income. |
Similar content being viewed by others
Abbreviations
- GLM:
-
General linear regression model
- NM:
-
Neisseria meningitidis meningitis
- OR:
-
Odds ratio
References
Brouwer MC, Read RC, van de Beek D (2010) Host genetics and outcome in meningococcal disease: a systematic review and meta-analysis. Lancet Infect Dis 10:262–274
Zalmanovici Trestioreanu A, Fraser A, Gafter-Gvili A, Paul M, Leibovici L (2013) Antibiotics for preventing meningococcal infections. Cochrane Database Syst Rev:Cd004785
Krcmery V, Fedor-Freybergh PG (2007) Neuroinfections in developed versus developing countries. Neuro endocrinol lett 28(Suppl 2):5–6
Wolfson LJ, Gasse F, Lee-Martin SP, Lydon P, Magan A, Tibouti A, Johns B, Hutubessy R, Salama P, Okwo-Bele JM (2008) Estimating the costs of achieving the WHO-UNICEF global immunization vision and strategy, 2006–2015. Bull World Health Organ 86:27–39
Bodilsen J, Dalager-Pedersen M, Schonheyder HC, Nielsen H (2014) Stroke in community-acquired bacterial meningitis: a Danish population-based study. Int J Infect Dis 20:18–22
Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, Bettinger JA (2015) Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study. Clin Infect Dis 60:e27–e35
Stein-Zamir C, Shoob H, Sokolov I, Kunbar A, Abramson N, Zimmerman D (2014) The clinical features and long-term sequelae of invasive meningococcal disease in children. Pediatr Infect Dis J 33:777–779
Stevens JP, Eames M, Kent A, Halket S, Holt D, Harvey D (2003) Long term outcome of neonatal meningitis. Arch Dis Child Fetal Neonatal Ed 88:F179–F184
Mai NT, Hoa NT, Nga TV, Linh le D, Chau TT, Sinh DX, Phu NH, Chuong LV, Diep TS, Campbell J, Nghia HD, Minh TN, Chau NV, de Jong MD, Chinh NT, Hien TT, Farrar J, Schultsz C (2008) Streptococcus suis meningitis in adults in Vietnam. Clin Infect Dis 46:659–667
Pedersen CB, Gotzsche H, Moller JO, Mortensen PB (2006) The Danish Civil Registration System. A cohort of eight million persons. Dan Med Bull 53:441–449
Jennum P, Pickering L, Christensen J, Ibsen R, Kjellberg J (2016) Welfare cost of childhood- and adolescent-onset epilepsy: a controlled national study. Epilepsy Behav 61:72–77
Jennum P, Wanscher B, Frederiksen J, Kjellberg J (2012) The socioeconomic consequences of multiple sclerosis: a controlled national study. Eur Neuropsychopharmacol 22:36–43
Jennum P, Pickering L, Thorstensen EW, Ibsen R, Kjellberg J (2017) Morbidity of childhood onset narcolepsy: a controlled national study. Sleep Med 29:13–17
Jennum P, Christensen J, Ibsen R, Kjellberg J (2016) Long-term socioeconomic consequences and health care costs of childhood and adolescent-onset epilepsy. Epilepsia 57:1078–1085
Jennum P, Ibsen R, Petersen ER, Knudsen S, Kjellberg J (2012) Health, social, and economic consequences of narcolepsy: a controlled national study evaluating the societal effect on patients and their partners. Sleep Med 13:1086–1093
Simony SB, Lund LW, Erdmann F, Andersen KK, Winther JF, Schuz J, Johansen C, Schmiegelow K, Dalton SO (2016) Effect of socioeconomic position on survival after childhood cancer in Denmark. Acta Oncol 55:742–750
Howitz M, Lambertsen L, Simonsen JB, Christensen JJ, Molbak K (2009) Morbidity, mortality and spatial distribution of meningococcal disease, 1974-2007. Epidemiol Infect 137:1631–1640
Howitz MF, Simonsen J, Krause TG, Robbins JB, Schneerson R, Molbak K, Miller MA (2009) Risk of adverse birth outcome after group B meningococcal disease: results from a Danish national cohort. Pediatr Infect Dis J 28:199–203
Funding
The study received internal funding from the Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Rigshospitalet, Denmark. The funder had no influence on the study design, the collection, analysis or interpretation of the data, the writing of the report, or the decision to submit the paper for publication.
The study is a national register study approved by the Statistics Denmark.
Author information
Authors and Affiliations
Contributions
PJ and JK were responsible for the creation, initiation, and management of the project. LP is the main author. RI performed the statistical analyses and commented on the manuscript. LP commented on the methods. All authors commented and approved the final version of the manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Additional information
Communicated by Nicole Ritz
Rights and permissions
About this article
Cite this article
Pickering, L., Jennum, P., Ibsen, R. et al. Long-term health and socioeconomic consequences of childhood and adolescent onset of meningococcal meningitis. Eur J Pediatr 177, 1309–1315 (2018). https://doi.org/10.1007/s00431-018-3192-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-018-3192-0