title: Relationships Between Clinico-Epidemiological Patterns of Invasive Meningococcal Infections and Complement Deficiencies in French South Pacific Islands (New Caledonia).
abstract: OBJECTIVE
  Invasive Meningococcal Disease (IMD) is three fold more common in New Caledonia (NC) than in metropolitan France and many IMD cases (35.7%) are due to Y and W135 serogroups. The purpose of our study was to identify IMD risk factors in NC.
  
  
  METHODS
  A retrospective study of all IMD cases that occurred in NC between 2005 and 2011 was conducted. Socio-environmental, clinical and biological data were collected. A search for immune deficiency was proposed to all cases. IMD presentation and outcome were compared according to meningoccal serogroups and the complement deficiency status (C-deficiency).
  
  
  RESULTS
  Sixty-six sporadic IMD cases (29 B serogroup, 20 Y or W135, 6 C, 1 A, 10 unknown) occurred in 64 patients often <24 years-old and of Melanesian origin. Five patients died (7.8%). No socio-environmental risk factors were identified. No asplenia, HIV infection or immunoglobulin deficiencies were found. Two patients had diabetes and 28 of 53 (52.8%) patients had C-deficiency including 20 (71.4%) cases of late complement component deficiency. Patients with C-deficiency were mainly Melanesian (92.8%) originating from the Loyalty Islands (62.1%). They were mostly infected with Y/W135 (42.9%) or B serogroups (32.1%). They often developed later and more severe disease than patients without C-deficiency (need for intensive cares in 60% versus 28.0% of cases, p = 0.01).
  
  
  CONCLUSIONS
  A high prevalence of C-deficiency in the Melanesian population may explain epidemiological and clinical features of IMD in NC. Our results imply an adaptation of meningococcal vaccine strategies in NC.
authors.affiliation: Public Health Service, New Caledonia Health Department, BP N4 - 98851, Nouméa, Cédex, New Caledonia. maguy.daures@gmail.com.
authors.forename: Maguy
authors.initials: M
authors.lastname: Daures
authors.affiliation: Public Health Service, New Caledonia Health Department, BP N4 - 98851, Nouméa, Cédex, New Caledonia.
authors.forename: Michele
authors.initials: M
authors.lastname: John
authors.affiliation: Laboratory of Immunology, Team 2267, Claude Bernard University, Lyon, France.
authors.forename: Cécile Veysseyre
authors.initials: CV
authors.lastname: Balter
authors.affiliation: Neurology Department, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Olivier
authors.initials: O
authors.lastname: Simon
authors.affiliation: Biochemistry and Haemostasis Laboratory, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Yann
authors.initials: Y
authors.lastname: Barguil
authors.affiliation: Paediatrics Department, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Missotte
authors.affiliation: Public Health Service, New Caledonia Health Department, BP N4 - 98851, Nouméa, Cédex, New Caledonia.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Grangeon
authors.affiliation: Public Health Service, New Caledonia Health Department, BP N4 - 98851, Nouméa, Cédex, New Caledonia.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Laumond-Barny
authors.affiliation: Public Health Service, New Caledonia Health Department, BP N4 - 98851, Nouméa, Cédex, New Caledonia.
authors.forename: Martine
authors.initials: M
authors.lastname: Noel
authors.affiliation: Paediatrics Department, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Laurent
authors.initials: L
authors.lastname: Besson-Leaud
authors.affiliation: Department of Internal Medicine, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Spasic
authors.affiliation: Paediatrics Department, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Aurélie
authors.initials: A
authors.lastname: de Suremain
authors.affiliation: Laboratory of Serology and Molecular Diagnosis, Pasteur Institute, Noumea, New Caledonia.
authors.forename: Ann-Claire
authors.initials: AC
authors.lastname: Gourinat
authors.affiliation: Department of Internal Medicine, Noumea Territorial Hospital, Noumea, New Caledonia.
authors.forename: Elodie
authors.initials: E
authors.lastname: Descloux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003165:Complement System Proteins / Q000172:deficiency*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000276:immunology* / Q000382:microbiology; D008875:Middle Aged; D038541:Neisseria meningitidis, Serogroup B; D038582:Neisseria meningitidis, Serogroup W-135; D038581:Neisseria meningitidis, Serogroup Y; D009510:New Caledonia / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003165:Complement System Proteins
keywords: Complement deficiency; melanesian population; meningococcal disease; risk factors