title: [Invasive meningococcal disease in Navarra in the era of a meningococcal C vaccine].
abstract: BACKGROUND
  Systematic childhood vaccination against meningococcus C has had a considerable impact on meningococcal invasive disease (MID). The aim of this study is to perform an analysis on the epidemiology, the clinical features, and the factors associated with a worse prognosis of MID, in the era of a meningococcal C vaccine.
  
  
  METHODS
  The study included confirmed cases of MID in children less than 15 years of age in Navarra, Spain, between 2008 and 2014. The risk of death or permanent sequelae was evaluated according to the presence of clinical features and analytical parameters at diagnosis.
  
  
  RESULTS
  The average annual incidence was 7.9 cases per 100,000 children, with the highest attack rate in children < 1 year. Of 53 cases analysed, 87% were due to meningococcus B. Fever (100%), rash (91%), and elevation of procalcitonin (94%) were the most frequent findings at diagnosis. Some sign of shock was observed in 70% upon arrival at the hospital. The case-fatality rate was 3.8% and 10 % survived with permanent sequelae. Glasgow coma scale < 15 (odds ratio [OR]= 9.2), seizure (OR=8.3), sepsis without meningitis (OR=9.1), thrombocytopenia (OR=30.5), and disseminated intravascular coagulation (OR= 10.9) showed a greater association with a worse prognosis.
  
  
  CONCLUSIONS
  The MID continues to be a significant cause of morbidity and mortality in children. Therefore, new advances are needed in the prevention, early diagnosis, and detection of the factors associated with poor prognosis.
authors.affiliation: Centro de Salud de Noáin, Noáin, Navarra, España. Electronic address: desiree.morales.senosiain@cfnavarra.es.
authors.forename: Desirée
authors.initials: D
authors.lastname: Morales
authors.affiliation: Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Moreno
authors.affiliation: Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Herranz
authors.affiliation: Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España.
authors.forename: Enrique
authors.initials: E
authors.lastname: Bernaola
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Instituto de Salud Pública de Navarra, Pamplona, Navarra, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España.
authors.forename: Iván
authors.initials: I
authors.lastname: Martínez-Baz
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Instituto de Salud Pública de Navarra, Pamplona, Navarra, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Castilla
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine
keywords: Características clínicas; Clinical features; Conjugate vaccine; Enfermedad meningocócica; Epidemiology; Epidemiología; Factores pronósticos; Meningococcal disease; Prognostic factors; Vacuna conjugada