Sex Difference in Meningococcal Disease Mortality, New York City, 2008–2016

Bloch, Danielle; Murray, Kenya; Peterson, Eric; Ngai, Stephanie; Rubinstein, Inessa; Halse, Tanya A.; Ezeoke, Ifeoma; Miller, Laura J.; Arakaki, Lola; Ramautar, Arianne; Antwi, Mike; Rosso, Paula Del; Dorsinville, Marie; Clark, Sandhya; Halbrook, Megan; Kennedy, Joseph; Braunstein, Sarah L.; Weiss, Don

doi:10.1093/cid/ciy183

Cited by 11 publications

(8 citation statements)

References 35 publications

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“…There is evidence that the IR for meningococcal disease differ between the sexes, based on population-based studies, case series and case−control studies [11][12][13][14][15]. In addition, in several studies case-fatality rates were higher among females [16][17][18]. On the other hand, female infants appear to develop a stronger immune response to group C meningococcal vaccine [19].…”

Section: Introductionmentioning

confidence: 99%

A meta-analytic evaluation of sex differences in meningococcal disease incidence rates in 10 countries

2020

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The magnitude and consistency of the sex differences in meningococcal disease incidence rates (IR) have not been systematically examined in different age groups, countries and time periods. We obtained national data on meningococcal disease IR by sex, age group and time period, from 10 countries. We used meta-analytic methods to combine the male to female incidence rate ratios (IRRs) by country and year for each age group. Meta-regression analysis was used to assess the contribution of age, country and time period to the variation in the IRRs. The pooled male to female IRRs (with 95% CI) for ages 0–1, 1–4, 5–9, 10–14 and 15–44, were 1.25 (1.19–1.32), 1.24 (1.20–1.29), 1.13 (1.07–1.20), 1.21 (1.13–1.29) and 1.15 (1.10–1.21), respectively. In the age groups 45−64 and over 65, the IR were lower in males with IRRs of 0.83 (0.78–0.88) and 0.64 (0.60–0.69), respectively. Sensitivity analysis and meta-regression confirmed that the results were robust. The excess meningococcal IR in young males and the higher rates in females at older ages were consistent in all countries, except the Czech Republic. While behavioural factors could explain some of the sex differences in the older age groups, the excess rates in very young males suggest that genetic and hormonal differences could be important.

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Section: Introductionmentioning

confidence: 99%

A meta-analytic evaluation of sex differences in meningococcal disease incidence rates in 10 countries

2020

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“…But another study regarding invasive meningococcal disease in New York City found that the mortality rate of female patients with hydrocephalus was 13 times that of male, which the author speculated that it may be related to differences in immune response due to sex hormone level. 21 Our study showed that female sex was a predictor for hydrocephalus, but female patients did not exhibit a worse outcome than male patients at discharge. Therefore, our results only suggest that female newborns are more likely to develop hydrocephalus in meningitis, as to whether there is a poor prognosis may require further analysis.…”

Section: Discussionmentioning

confidence: 48%

Risk Factors for Hydrocephalus in Neonatal Purulent Meningitis: A Single-Center Retrospective Analysis

et al. 2021

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Objective: Hydrocephalus is a potentially lethal complication of neonatal purulent meningitis. Early detection of hydrocephalus helps to determine optimal treatment, improve prognosis, and reduce financial burden. We aimed to analyze the risk factors for hydrocephalus in neonates with purulent meningitis and discuss the characteristics of the disease. Methods: The records of neonatal purulent meningitis admitted to the Children Hospital of Fudan University from January 2013 to September 2019 were retrospectively included in the study cohort. The data of clinical, laboratory, and cranial magnetic resonance images (MRIs) were collected and analyzed (except discharge data) by univariate analysis, and P values <.05 were further analyzed by multivariate logistic regression. Results: A total of 197 children who met the inclusion criteria were enrolled in the study cohort. Overall, 39.6% (78/197) of the patients had positive pathogen cultures, and 60.4% (119/197) of patients had clinical diagnosis of meningitis with negative pathogen cultures. Among 197 children, 67 of them experienced hydrocephalus, and the factors that were significantly associated with hydrocephalus in multivariate analysis were female sex, cerebrospinal fluid glucose <2 mmol/L, periventricular leukomalacia, punctate white matter lesions, and pyogenic intraventricular empyema. Children with hydrocephalus had a lower cure rate of meningitis (31.3% vs 75.4%), and poor discharge outcomes. In addition, they had longer length of hospital stay and higher hospital cost. Conclusions: Female sex, cerebrospinal fluid glucose <2 mmol/L, periventricular leukomalacia, punctate white matter lesions, and pyogenic intraventricular empyema were identified as risk factors for hydrocephalus in neonatal purulent meningitis. Children with hydrocephalus had poor discharge outcomes and increased financial burden on their families.

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“…Another notable feature is that the CFR among females (39.5%) was much higher than for males (19.0%) in those 2 years, but the contributing risk factor was unclear. The finding of females with a higher CFR than males has been observed in New York City, NY, USA ( 38 ), but the effect of sex on mortality in IMD was not supported by the results from the surveillance data from 21 European countries ( 39 ).…”

Section: Discussionmentioning

confidence: 89%

Demographic Features of Invasive Meningococcal Disease in Taiwan, 1993 to 2020, and Genetic Characteristics of Neisseria meningitidis Isolates, 2003 to 2020

et al. 2022

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N. meningitidis can cause life-threatening invasive meningococcal disease (IMD), including meningitis and sepsis, resulting in a high CFR and long-term sequelae in survivors. Here, we report the demographic features of IMD in Taiwan over a 28-year period (1993 to 2020) and the genetic characteristics of N. meningitidis isolates recovered from patients with IMD over an 18-year period (2003 to 2020).

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Sex Difference in Meningococcal Disease Mortality, New York City, 2008–2016

Cited by 11 publications

References 35 publications

A meta-analytic evaluation of sex differences in meningococcal disease incidence rates in 10 countries

A meta-analytic evaluation of sex differences in meningococcal disease incidence rates in 10 countries

Risk Factors for Hydrocephalus in Neonatal Purulent Meningitis: A Single-Center Retrospective Analysis

Demographic Features of Invasive Meningococcal Disease in Taiwan, 1993 to 2020, and Genetic Characteristics of Neisseria meningitidis Isolates, 2003 to 2020

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