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Relationships Between Clinico-Epidemiological Patterns of Invasive Meningococcal Infections and Complement Deficiencies in French South Pacific Islands (New Caledonia)

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Abstract

Purpose

Invasive Meningococcal Disease (IMD) is three fold more common in New Caledonia (NC) than in metropolitan France and many IMD cases (35.7 %) are due to Y and W135 serogroups. The purpose of our study was to identify IMD risk factors in NC.

Methods

A retrospective study of all IMD cases that occurred in NC between 2005 and 2011 was conducted. Socio-environmental, clinical and biological data were collected. A search for immune deficiency was proposed to all cases. IMD presentation and outcome were compared according to meningoccal serogroups and the complement deficiency status (C-deficiency).

Results

Sixty-six sporadic IMD cases (29 B serogroup, 20 Y or W135, 6 C, 1 A, 10 unknown) occurred in 64 patients often <24 years-old and of Melanesian origin. Five patients died (7.8 %). No socio-environmental risk factors were identified. No asplenia, HIV infection or immunoglobulin deficiencies were found. Two patients had diabetes and 28 of 53 (52.8 %) patients had C-deficiency including 20 (71.4 %) cases of late complement component deficiency. Patients with C-deficiency were mainly Melanesian (92.8 %) originating from the Loyalty Islands (62.1 %). They were mostly infected with Y/W135 (42.9 %) or B serogroups (32.1 %). They often developed later and more severe disease than patients without C-deficiency (need for intensive cares in 60 % versus 28.0 % of cases, p = 0.01).

Conclusions

A high prevalence of C-deficiency in the Melanesian population may explain epidemiological and clinical features of IMD in NC. Our results imply an adaptation of meningococcal vaccine strategies in NC.

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Acknowledgments

We are grateful to Sylvie Tardieu from the medical laboratory of Koumac Hospital for her help in transferring the samples from the North of NC, the team of the Biochemistry and Haemostasis Laboratory of the Territorial Hospital in Noumea who carried out the sample analysis, Luc Monimeau from New Caledonia Health Department for the maps and the teams from hospital of Koumac and Poindimie. We also thank Mr Roy Benyon from the Secretariat of the Pacific Community for his help in English translation.

Conflict of Interest

All authors declare that no commercial or other association that might pose a conflict of interest exists.

Funding

This work was supported by the New Caledonia Health Department.

Meeting presentation

FORUM: Public Health Watch and response in island territories June 2013 - Reunion Island

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Authors and Affiliations

  1. Public Health Service, New Caledonia Health Department, BP N4 - 98851, Nouméa, Cédex, New Caledonia

    Maguy Daures, Michele John, Jean-Paul Grangeon, Sylvie Laumond-Barny & Martine Noel

  2. Laboratory of Immunology, Team 2267, Claude Bernard University, Lyon, France

    Cécile Veysseyre Balter

  3. Neurology Department, Noumea Territorial Hospital, Noumea, New Caledonia

    Olivier Simon

  4. Biochemistry and Haemostasis Laboratory, Noumea Territorial Hospital, Noumea, New Caledonia

    Yann Barguil

  5. Paediatrics Department, Noumea Territorial Hospital, Noumea, New Caledonia

    Isabelle Missotte, Laurent Besson-Leaud & Aurélie de Suremain

  6. Department of Internal Medicine, Noumea Territorial Hospital, Noumea, New Caledonia

    Pierre-Emmanuel Spasic & Elodie Descloux

  7. Laboratory of Serology and Molecular Diagnosis, Pasteur Institute, Noumea, New Caledonia

    Ann-Claire Gourinat

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  1. Maguy Daures
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Correspondence to Maguy Daures.

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Daures, M., John, M., Balter, C.V. et al. Relationships Between Clinico-Epidemiological Patterns of Invasive Meningococcal Infections and Complement Deficiencies in French South Pacific Islands (New Caledonia). J Clin Immunol 35, 47–55 (2015). https://doi.org/10.1007/s10875-014-0104-6

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