[Fatality rates of bacterial meningitis from current health databases suggest a different case definition. Results of a follow-up study of bacterial meningitis in Lazio Region, Italy, 1996-2000].
OBJECTIVE
To describe mortality and case fatality rate due to bacterial meningitis in the Lazio Region from 1996 to 2000, and to compare these estimates with those from Cause-of-death Registry (CDR) and Hospital Discharge Registry (HDR).


METHODS
A follow-up study of mortality was conducted through Registry Offices for bacterial meningitis cases reported to surveillance in 1996-2000 among residents in the Lazio Region. Death due to bacterial meningitis was defined as a patient who died during a hospitalization for meningitis or who died within 30 days after hospitalization and whose underlying cause of death was bacterial meningitis (ICD-9: 036.0, 036.1, 036.2,320.0, 320.1, 320.2, 320.3, 320.7, 320.8, 320.9, 027.0). Case fatality rates estimated from follow-up study were compared with estimates from CDR and HDR of the same period.


RESULTS
525 bacterial meningitis cases were reported among residents in the whole period; 98 deaths were detected with a case fatality rate (CFR) of 18.7% (CI 95% 15.4-22.5); estimates were higher in patients 64+ year old (44.6%; CI 95% 33.7-55.9) and in meningitis due to Streptococcus pneumoniae (27.5%; CI 95% 20.3-35.6) or Listeria (32.0%; CI 95% 14.9-53.5). The CFR was 10.1% according to the CDR and 10.9% according to the HDR.


CONCLUSIONS
CFRs differ according to the database used. Differences may be partially due to a selective lower sensitivity in reporting deceased cases, but the most important factor seems to be the case definition used in follow-up study and other sources of data.
Sangalli
Massimo
M
Osservatorio epidemiologico ASL RME, presso il Ministero affari esteri, Roma.
Palange
Stefania
S
Fabrizi
Emanuele
E
Faustini
Annunziata
A
Perucci
Carlo A
CA
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003628:Database Management Systems; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality*; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D015996:Survival Rate