Advertisement

European Journal of Pediatrics

, Volume 177, Issue 9, pp 1309–1315 | Cite as

Long-term health and socioeconomic consequences of childhood and adolescent onset of meningococcal meningitis

  • Line Pickering
  • Poul Jennum
  • Rikke Ibsen
  • Jakob Kjellberg
Original Article

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.

Keywords

Neisseria meningitidis Meningitis Morbidity Mortality Health Socioeconomic 

Abbreviations

GLM

General linear regression model

NM

Neisseria meningitidis meningitis

OR

Odds ratio

Notes

Authors’ 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.

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.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    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 10:262–274CrossRefPubMedGoogle Scholar
  2. 2.
    Zalmanovici Trestioreanu A, Fraser A, Gafter-Gvili A, Paul M, Leibovici L (2013) Antibiotics for preventing meningococcal infections. Cochrane Database Syst Rev:Cd004785Google Scholar
  3. 3.
    Krcmery V, Fedor-Freybergh PG (2007) Neuroinfections in developed versus developing countries. Neuro endocrinol lett 28(Suppl 2):5–6PubMedGoogle Scholar
  4. 4.
    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 86:27–39CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    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 20:18–22CrossRefPubMedGoogle Scholar
  6. 6.
    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–e35CrossRefPubMedGoogle Scholar
  7. 7.
    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 33:777–779CrossRefPubMedGoogle Scholar
  8. 8.
    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–F184CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    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 46:659–667CrossRefPubMedGoogle Scholar
  10. 10.
    Pedersen CB, Gotzsche H, Moller JO, Mortensen PB (2006) The Danish Civil Registration System. A cohort of eight million persons. Dan Med Bull 53:441–449PubMedGoogle Scholar
  11. 11.
    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 61:72–77CrossRefPubMedGoogle Scholar
  12. 12.
    Jennum P, Wanscher B, Frederiksen J, Kjellberg J (2012) The socioeconomic consequences of multiple sclerosis: a controlled national study. Eur Neuropsychopharmacol 22:36–43CrossRefPubMedGoogle Scholar
  13. 13.
    Jennum P, Pickering L, Thorstensen EW, Ibsen R, Kjellberg J (2017) Morbidity of childhood onset narcolepsy: a controlled national study. Sleep Med 29:13–17CrossRefPubMedGoogle Scholar
  14. 14.
    Jennum P, Christensen J, Ibsen R, Kjellberg J (2016) Long-term socioeconomic consequences and health care costs of childhood and adolescent-onset epilepsy. Epilepsia 57:1078–1085CrossRefPubMedGoogle Scholar
  15. 15.
    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 13:1086–1093CrossRefPubMedGoogle Scholar
  16. 16.
    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 55:742–750CrossRefPubMedGoogle Scholar
  17. 17.
    Howitz M, Lambertsen L, Simonsen JB, Christensen JJ, Molbak K (2009) Morbidity, mortality and spatial distribution of meningococcal disease, 1974-2007. Epidemiol Infect 137:1631–1640CrossRefPubMedGoogle Scholar
  18. 18.
    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 28:199–203CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Line Pickering
    • 1
  • Poul Jennum
    • 1
  • Rikke Ibsen
    • 2
  • Jakob Kjellberg
    • 3
  1. 1.Danish Center for Sleep Medicine, Department of Clinical NeurophysiologyUniversity of CopenhagenGlostrupDenmark
  2. 2.i2mindsAarhusDenmark
  3. 3.The Danish Center for Social Science ResearchCopenhagenDenmark

Personalised recommendations