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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Don Weiss, MD, MPH, Alexandre Sampaio-Moura, MD, Katie Bornschlegel, MPH, and Marcelle Layton, MD. Communicable Disease Program, New York City Department of Health, 125 Worth St, Box 22a, New York, NY 10013, (212) 941-2265, dweiss@health.nyc.gov
Although the incidence rate of meningococcal disease in NYC is low (0.6/100,000), the case fatality rate (CFR) exceeds national figures by 60%. Methods- All confirmed meningococcal cases reported to NYC from 1989-2000 were reviewed. Death certificate matching was also performed and those missing outcome were considered survivors. Logistic regression was used to evaluate the contribution of age, race, sex, disease presentation, serogroup, United Hospital Fund (UHF) neighborhood, unemployment and poverty to mortality. Results-The overall CFR for the period was 17% (96/578). Univariable predictors of mortality were age, serogroup A, meningococcemia disease presentation and UHF neighborhoods 21 and 35 (p< 0.05). In multivariable analysis age, serogroup A and residence in either UHF 21 or UHF 35 remained statistically significant. Serogroup A case-patients were 4.0 times more likely (95% C.I.: 1.1, 15.5) to die than all others serogrouped and non-grouped. Odds ratios for fatal outcome for case-patients with residence in UHF 21(Central Bronx) and UHF 35 (Southeastern Brooklyn) controlling for age and serogroup A were 4.5 (95% C.I.:1.7, 11.7) and 3.8 (95% C.I.: 1.5, 9.2) respectively. Discussion- Serogroup A represented 1.6% of menigococcal cases and caution should be employed when interpreting this result. UHF neighborhood residence may serve as a proxy for other non-measured socioeconomic variables that may relate to meningococcal outcome. Poverty and unemployment data were not available for individual cases and proxy measures were used. Conclusions-The case fatality rate for meningococcal disease in NYC is elevated and the contribution of neighborhood of residence requires further epidemiologic study.
Learning Objectives:
Keywords: Infectious Diseases, Mortality
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.