Outcomes of meningococcal disease in adolescence: prospective, matched-cohort study.
OBJECTIVE
We examined the physical, cognitive, educational, social, and psychological outcomes of invasive meningococcal disease in adolescence, as well as demographic and disease factors associated with outcomes.


METHODS
A population-based, matched-cohort study was performed. A total of 101 gender- and age-matched case-control pairs (15-19 years of age at the time of disease; 46% male) from 6 regions of England underwent follow-up evaluations 18 to 36 months after invasive meningococcal disease. Educational, social, and vocational function, mental health, social support, self-efficacy, and quality-of-life data were collected by using standardized questionnaires and neuropsychological tests.


RESULTS
Fifty-seven percent of case subjects (n = 58) had major physical sequelae. Survivors had greater depressive symptoms, greater fatigue, less social support, greater reduction in quality of life, and lower educational attainment compared with control subjects. Survivors with serogroup C disease had greater physical sequelae than did those with serogroup B disease. Greater cognitive deficits were associated with younger age at diagnosis. Only 53 of 101 case subjects reported any medical follow-up care after invasive meningococcal disease.


CONCLUSIONS
Survivors of invasive meningococcal disease in adolescence have a disturbing series of deficits, including poorer physical and mental health, quality of life, and educational achievement. Serogroup C is associated with poorer outcomes. Invasive meningococcal disease attributable to serogroup B disease remains a major cause of morbidity and death among adolescents. Medical care is poor after discharge from the hospital. Routine follow-up care of adolescent survivors may prevent or ameliorate physical and psychosocial morbidity after invasive meningococcal disease.
Borg
Jennie
J
MBBS, University College Hospital, Department of Paediatrics, 250 Euston Rd, London NW1 2PG, United Kingdom.
Christie
Deborah
D
Coen
Pietro G
PG
Booy
Robert
R
Viner
Russell M
RM
D000293:Adolescent; D000359:Aftercare; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004185:Disability Evaluation; D004522:Educational Status; D004739:England; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D038541:Neisseria meningitidis, Serogroup B; D038542:Neisseria meningitidis, Serogroup C; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life; D012050:Rehabilitation, Vocational; D020377:Self Efficacy; D012944:Social Support; D055815:Young Adult