Estimation of the real burden of invasive meningococcal disease in Argentina

Abstract

Among the different existing types of bacterial meningitis, the one caused by Neisseria meningitidis is the main presentation of invasive meningococcal disease (IMD). IMD is a significant public health concern and has a reported incidence rate in Argentina of 0.44 cases per 100 000 inhabitants in 2015. However, the actual incidence is thought to be higher as passive surveillance systems neither report nor identify 100% of all cases. The aim of this study is to develop an estimation of the burden of IMD in Argentina closer to reality by adjusting/correcting several limitations observed in the surveillance data available. A retrospective observational study has been performed using four Argentinean national databases recording the number of IMD cases and deaths, serogroups of N. meningitidis and ages, between 2007 to 2016. The reported data were adjusted to account for underreporting and to also integrate the cases missed due to well-known limitations associated with the diagnosis of N. meningitidis detection methods. Data were further analysed by serogroups of N. meningitidis and by age groups. After these adjustments, the potential numbers of IMD cases and IMD-related deaths are estimated to be 3.1 and 1.9 higher than reported, respectively. The study corrects the previous underestimation of the disease burden and provides expectedly more robust estimates aligned with international evidence and highlights the importance of active surveillance, with high-quality methods, for a better definition of preventive strategies against IMD in Argentina.

Invasive meningococcal disease in South-Eastern European countries: Do we need to revise vaccination strategies?

“…This may be due to incomplete reporting and may include misdiagnoses, leading to underestimation of the true burden of IMD. 34 , 35 As such, compulsory surveillance or laboratory-based reporting is preferred. Further, access to molecular-based methodologies, such as polymerase chain reaction (PCR) and whole genome sequencing (WGS), is vital to not only to improve diagnostic accuracy and allow timely treatment, but also to inform future vaccination strategies.…”

Epidemiology, clinical features and outcome of adults with meningococcal meningitis: a 15-year prospective nationwide cohort study

“… 25 , 26 A decrease in MenW cases was also in reported in Argentina, although the incidence was reported to decrease two years prior to the implementation of routine vaccination. 27 During the COVID-19 pandemic, non-pharmacological intervention measures were implemented in March 2020, which were associated with reduction of many infectious diseases. 28 , 29 , 30 Potentially, a rebound of (meningococcal) meningitis may occur in the Netherlands, as resurgence of respiratory infections has occurred after relaxation of restriction measures against COVID-19.…”

Estimation of the incidence of invasive meningococcal disease using a capture–recapture model based on two independent surveillance systems in Catalonia, Spain

“…This suggests there was under-reporting, despite the clinical severity of the disease. Other authors have also found under-reporting of this disease 40. It is very important to improve reporting by all physicians and microbiologists to the SDR and MRS to assess the impact of interventions such as immunisation.…”