title: Epidemiology of meningococcal disease in the Panamanian pediatric population, 1998-2008.
abstract: BACKGROUND
  Worldwide public health authorities report 500,000 cases of invasive meningococcal disease with 50,000 deaths per year and 10-15% of sequelae in people affected. This study describes the epidemiology, microbiology, and clinical presentation of this disease in the Panamanian pediatric population.
  
  
  METHODS
  The discharge of patients with a meningococcal invasive disease diagnosis was reviewed in the statistical database and archives of the Hospital del Niño.
  
  
  RESULTS
  A total of 32 discharges with a meningococcal disease diagnosis were reported during the study period (1998-2008).  Ninety-one percent (n/N = 29/32) were confirmed as meningitis. The mean age of patients was 4.1 ± 4.6 years. The incidence in the period of the study was 0.25/100,000. Infants younger than one year old presented the highest incidence rate and number of cases. Four deaths were reported, three of which occurred in the group of 10-14 years and one in the group of 1-4 years. The overall fatality rate was 12.5%. The serogroup of the causative agent, Neisseria meningitidis, was documented in 30 of the 32 cases, with serogroup B the most frequent (66.7%). Ninety-percent (18/20) of serogroup B were isolated in the first five years of study. Serogroup C was identified in 8 of the 12 cases during the period 2004-2008.
  
  
  CONCLUSIONS
  The present study showed a change in the epidemiological circulation pattern from serogroup B to serogroup C during the study period. Such epidemiological surveillance data is important in the implementation of preventive measures such as vaccination.
authors.affiliation: Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama. nietdom@gmail.com
authors.forename: Javier
authors.initials: J
authors.lastname: Nieto-Guevara
authors.forename: Kathia
authors.initials: K
authors.lastname: Luciani
authors.forename: Abian
authors.initials: A
authors.lastname: Montesdeoca-Melían
authors.forename: Mercedes
authors.initials: M
authors.lastname: Mateos-Durán
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D010176:Panama / Q000453:epidemiology; D012703:Serotyping