Meningococcal disease in Wales: Clinical features, outcome and public health management

Palmer, S.R.; Corson, J.; Hall, Robert; Payne, Susan F.; Ludlow, J.; Deere, Bradley; Jones, H; Kaul, S. M.; Stubbins, J.; Williams, Roxanne E.; Walapu, M.; Spence, Andrea R.; Jenkins, Paul; Donald, Dan C.

doi:10.1016/0163-4453(92)91699-c

Cited by 24 publications

(14 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Current knowledge on the presentation of meningococcal disease has been defined largely from the results of studies based in hospitals, where the disease is seen at a late stage 1 2 3 4 5 6 7 8. General practitioners encounter meningococcal disease earlier, when signs and symptoms are often non-specific, making diagnosis difficult.…”

Section: Introductionmentioning

confidence: 99%

Recognising meningococcal disease in primary care: qualitative study of how general practitioners process clinical and contextual information

Granier

Owen²,

Pill

et al. 1998

BMJ

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Recognising meningococcal disease in primary care: qualitative study of how general practitioners process clinical and contextual information

Granier

Owen²,

Pill

et al. 1998

BMJ

View full text Add to dashboard Cite

show abstract

“…The χ 2 for heterogeneity was 11.02 (P = 0.09), I 2 = 46% (95% uncertainty interval 0% to 77%). The proportion of cases treated differed among these studies, ranging from 15%23 to 59% (P < 0.001) 25. The results were similar when we included all 12 studies in the analysis (χ 2 for heterogeneity 16.94, P = 0.11).…”

Section: Resultsmentioning

confidence: 90%

“…The overall case fatality ratio was 6.0%, ranging from 3.3%14 to 14.6% 26. Twelve studies included both microbiologically confirmed and clinically diagnosed cases of meningococcal disease 8 14 – 16 18 – 23 25 26. Two studies included only microbiologically confirmed cases 17 24.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of antibiotics given before admission in reducing mortality from meningococcal disease: systematic review

Hahné

Charlett

Purcell

et al. 2006

BMJ

View full text Add to dashboard Cite

Objective To review the evidence for effectiveness of treatment with antibiotics before admission in reducing case fatality from meningococcal disease. Design Systematic review. Data sources Cochrane register of trials and systematic reviews, database of abstracts of reviews of effectiveness, health technology assessment, and national research register in England and Wales, Medline, Embase, and CAB Health. Included studies Studies describing vital outcome of at least 10 cases of meningococcal disease classified by whether or not antibiotics were given before admission to hospital. Results 14 observational studies met the review criteria. Oral antibiotic treatment given before admission was associated with reduced mortality among cases (combined risk ratio 0.17, 95% confidence interval 0.07 to 0.44). In seven studies in which all included patients were seen in primary care, the association between parenteral antibiotics before admission and outcome was inconsistent ( 2 for heterogeneity 11.02, P = 0.09). After adjustment for the proportion given parenteral antibiotics before admission, there was no residual heterogeneity. A higher proportion of patients given parenteral antibiotics before admission was associated with reduced mortality after such treatment and vice versa (P = 0.04). Conclusion Confounding by severity is the most likely explanation both for the beneficial effect of oral antibiotics and the harmful effect observed in some studies of parenteral antibiotics. We cannot conclude whether or not antibiotics given before admission have an effect on case fatality. The data are consistent with benefit when a substantial proportion of cases are treated.

show abstract

“…The mortality associated with group C disease is greater than that with group A disease [5], and may be similar to or greater than that due to group B disease [8]. Data are needed to estimate the benefit of vaccinating children against group C meningococci.…”

Section: Introductionmentioning

confidence: 98%

“…Neisseria meningitidis is an important cause of mortality and morbidity in children [8]. Although meningococcal disease (MCD) in the United Kingdom has mainly been caused by serogroup B meningococci [4] (for which an effective vaccine is not available), serogroup C organisms have recently increased in prevalence [6].…”

Section: Introductionmentioning

confidence: 99%

Mortality from group C meningococcal disease: a case for a conjugate vaccine?

et al. 1994

View full text Add to dashboard Cite

This 17-year retrospective review of children with meningococcal disease (MCD) has determined the mortality due to serogroup C, in order to assess the potential impact of a group C conjugate vaccine. Four hundred and forty-nine cases of MCD were admitted to our hospitals during 1977-1993; 78 due to group C, 11 of whom died. There was a significant increase in the proportion of cases due to group C from 1986 onwards (10% vs 21%), and an increase in the total number of cases of MCD (151 vs 298). The currently available group C polysaccharide vaccine has low efficacy below 2 years of age and could not have prevented 54 cases of group C disease. A conjugate group C vaccine administered between 2 and 4 months of age could have prevented 68 cases, including all fatal cases. The recent increase in MCD is partly due to an increase in group C disease. A meningococcal group C conjugate vaccine could prevent most cases of infection due to group C, and decrease the mortality from MCD by up to 30%.

show abstract

Meningococcal disease in Wales: Clinical features, outcome and public health management

Cited by 24 publications

References 8 publications

Recognising meningococcal disease in primary care: qualitative study of how general practitioners process clinical and contextual information

Recognising meningococcal disease in primary care: qualitative study of how general practitioners process clinical and contextual information

Effectiveness of antibiotics given before admission in reducing mortality from meningococcal disease: systematic review

Mortality from group C meningococcal disease: a case for a conjugate vaccine?

Contact Info

Product

Resources

About