Strifler Lisa, Morris Shaun K, Dang Vica, Tu Hong Anh T, Minhas Ripudaman S, Jamieson Frances B, Deeks Shelley L, Crowcroft Natasha S, Sander Beate
Knowledge Translation Program, St. Michael's Hospital.
Institute of Health Policy, Management and Evaluation, University of Toronto.
J Pediatric Infect Dis Soc. 2016 Dec;5(4):417-430. doi: 10.1093/jpids/piv065. Epub 2015 Oct 15.
Although relatively rare, invasive meningococcal disease continues to be a health concern, especially in young children. This systematic review clearly delineates both the near- and long-term morbidities that can occur after, and persist beyond, the period of acute illness.
Although rare, invasive meningococcal disease (IMD) continues to be a health concern in high-income countries because of its severe morbidity and relatively high case fatality rate, especially in young children. However, studies measuring sequelae of IMD across the spectrum of invasive syndromes have not been systematically reviewed. We conducted a systematic review of sequelae attributable to IMD and quality of life (QoL) in IMD survivors in high-income countries.
We searched Medline, Embase, and HealthSTAR for primary studies that assessed sequelae or QoL in individuals of any age with and without IMD. Two independent reviewers screened articles, abstracted data, and performed quality appraisal. The findings were summarized qualitatively.
Of 1884 citations screened, 17 studies were included. The most commonly assessed sequelae were hearing impairment, cognitive impairment, and psychological problems. In general, children with IMD had a greater incidence of hearing loss and psychological disorders, including attention-deficit/hyperactivity disorder. However, its effects on intelligence in children remain unclear. No statistical differences in overall cognitive function in adults were reported. The odds of death were significantly increased with IMD at hospital discharge and up to 30 years after disease. Lower overall QoL was observed in those who had IMD versus controls.
The results of this systematic review delineate both the short- and long-term morbidities that can occur after, and persist beyond, the period of acute illness. A better understanding of the full spectrum of IMD sequelae is critical for assessing the burden of IMD and supporting healthcare planning and decision making in light of new vaccines.
尽管侵袭性脑膜炎球菌病相对罕见，但仍是一个健康问题，尤其是在幼儿中。本系统评价明确描述了在急性疾病期之后及之后仍持续存在的近期和长期发病率。
尽管侵袭性脑膜炎球菌病（IMD）罕见，但在高收入国家，由于其严重的发病率和相对较高的病死率，尤其是在幼儿中，它仍然是一个健康问题。然而，尚未对侵袭性综合征范围内的IMD后遗症进行系统评价。我们对高收入国家IMD幸存者中IMD所致后遗症及生活质量（QoL）进行了系统评价。
我们检索了Medline、Embase和HealthSTAR，以查找评估有或无IMD的任何年龄个体的后遗症或QoL的原始研究。两名独立的评审员筛选文章、提取数据并进行质量评估。对研究结果进行定性总结。
在筛选的1884篇文献中，纳入了17项研究。最常评估的后遗症是听力障碍、认知障碍和心理问题。一般来说，患有IMD的儿童听力丧失和心理障碍（包括注意力缺陷多动障碍）的发生率更高。然而，其对儿童智力的影响仍不清楚。未报告成人总体认知功能的统计学差异。在出院时及疾病发生后长达30年，IMD患者的死亡几率显著增加。与对照组相比，患有IMD的患者总体生活质量较低。
本系统评价的结果描述了在急性疾病期之后及之后仍持续存在的短期和长期发病率。更好地了解IMD后遗症的全貌对于评估IMD的负担以及根据新疫苗支持医疗保健规划和决策至关重要。
