Lapi Francesco, Marconi Ettore, Vetrano Davide L, Rossi Alessandro, Lagolio Erik, Baldo Vincenzo, Cricelli Claudio
Health Search, Italian College of General Practitioners and Primary Care, 50142 Florence, Italy.
Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Fam Pract. 2025 Apr 12;42(3). doi: 10.1093/fampra/cmad062.
Invasive meningococcal disease (IMD) is a severe infectious disease. Although effective preventive and therapeutical strategies are available, the fatality rate remains high in the general population, with an occurrence of meningococcal-related severe sequelae involving 10-20% of survivors. Given the crucial role of general practitioners in recognizing and preventing IMD and its related sequelae, we aim to assess the burden of these conditions in primary care.
Using an Italian primary care database, the incidence rate of IMD was calculated in the period 2000-2019 by capturing the first diagnosis registered during follow-up. As far as meningococcal-related sequelae are concerned, we identified and clinically evaluated each potential sequela during the first 3 months, from 3 to 12 months, and up to 36 months.
Among 508 patients diagnosed with IMD, 403 (incidence rate: 0.24 per 10,000 person-years) comprised those diagnosed with IMD in patients aged 15 years or older. We ascertained 104 sequelae (20.4%); 76% of them occurred in those aged 25 or older; 42, 27, and 35 were assessed as short-, medium-, or long-term sequelae, respectively. Overall, 4.7% of IMD patients reported physical sequelae, while 12.2% and 5.7% of patients reported neurological and psychological sequelae, respectively.
Our study showed that a substantial proportion of IMD and related sequelae occur in individuals aged over 25, with a non-negligible burden for healthcare systems. As for the paediatric population, effective communication on the relevance of meningococcal vaccination in adults should be proficiently fostered.
侵袭性脑膜炎球菌病（IMD）是一种严重的传染病。尽管有有效的预防和治疗策略，但普通人群的死亡率仍然很高，10%-20%的幸存者会出现与脑膜炎球菌相关的严重后遗症。鉴于全科医生在识别和预防IMD及其相关后遗症方面的关键作用，我们旨在评估这些疾病在初级保健中的负担。
利用意大利初级保健数据库，通过记录随访期间首次诊断的病例，计算2000年至2019年期间IMD的发病率。至于与脑膜炎球菌相关的后遗症，我们在最初3个月、3至12个月以及长达36个月的时间内，对每一种潜在的后遗症进行了识别和临床评估。
在508例被诊断为IMD的患者中，403例（发病率：每10000人年0.24例）为15岁及以上患者中被诊断为IMD的病例。我们确定了104例后遗症（20.4%）；其中76%发生在25岁及以上的人群中；分别有42例、27例和35例被评估为短期、中期或长期后遗症。总体而言，4.7%的IMD患者报告有身体后遗症，而分别有12.2%和5.7%的患者报告有神经和心理后遗症。
我们的研究表明，相当一部分IMD及其相关后遗症发生在25岁以上的人群中，对医疗系统来说负担不可忽视。对于儿童人群，应大力加强关于成人脑膜炎球菌疫苗接种相关性的有效宣传。
