Journal of Tropical Pediatrics Advance Access originally published online on July 6, 2005
Journal of Tropical Pediatrics 2005 51(4):227-231; doi:10.1093/tropej/fmi006
Original Papers |
Risk Factors for Death from Meningococcal Infection in Recife, Brazil
1 Instituto Materno Infantil de Pernambuco, Recife, Brazil, 2 Liverpool School of Tropical Medicine, University of Liverpool, UK, 3 Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, UK
Correspondence: Maria C. M. B. Duarte, Paediatric Intensive Care Unit, Instituto Materno Infantil de Pernambuco, Rua dos Coelhos, 300 – Recife, PE, CEP 50070–550, Brazil. E-mail <mestrado{at}imip.org.br>.
To determine the case fatality rate and risk factors for death in children with invasive meningococcal infection, 163 children admitted with meningococcal disease to the Instituto Materno Infantil de Pernambuco, a tertiary paediatric teaching hospital in Recife, Brazil, were included in this retrospective cohort study. Cases were categorised as meningitis, septicaemia and septicaemia with meningitis. Forty-six (28.2 per cent) children had meningitis alone, 88 (54 per cent) septicaemia and meningitis and 29 (17.8 per cent) only septicaemia. Four of the patients with meningitis died (8.7 per cent), compared to 31 out of the 88 (35.2 per cent) with septicaemia and meningitis and 18 of the 29 (62.1 per cent) with septicaemia alone (p<0.001). Symptoms <24 h (AOR 3.8, 95 per cent CI 1.1–13.1), platelet count <100 000 mm3 (AOR 13.8, 95 per cent CI 3.1–60.9) and acidosis (AOR 6.0, 95 per cent CI 1.7–21) were the significant risk factors for death. Invasive meningococcal infection has a high case-fatality rate in this tertiary centre in Recife, especially in the septic forms. The identification of risk factors for death could contribute to the early recognition of patients with higher risk on admission in a middle-income country population.