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Review
. 2018 Dec;7(4):421-438.
doi: 10.1007/s40121-018-0213-2. Epub 2018 Sep 28.

Systematic Review of Invasive Meningococcal Disease: Sequelae and Quality of Life Impact on Patients and Their Caregivers

Kerstin J Olbrich  1 , Dirk Müller  2 , Sarah Schumacher  3 , Ekkehard Beck  3 , Kinga Meszaros  3 , Florian Koerber  4
Affiliations
Review

Systematic Review of Invasive Meningococcal Disease: Sequelae and Quality of Life Impact on Patients and Their Caregivers

Kerstin J Olbrich et al. Infect Dis Ther. 2018 Dec.

Abstract

Introduction: Invasive meningococcal disease (IMD, septicaemia and/or meningitis) has a severe acute and long-term burden: 5-10% of patients die within 48 h, and long-term sequelae have been reported in 10-20% of survivors. Health-related quality of life (HRQoL) is increasingly but inconsistently assessed.

Methods: A systematic literature review on Neisseria meningitidis IMD sequelae and HRQoL in survivors of all ages and their caregivers, including family, was conducted for high-income countries from 2001 to 2016 (in Medline and Embase, following Cochrane and PRISMA guidelines).

Results: A total of 31 studies, mostly of childhood IMD cases, were included. A broad range of physical, neurological and psychological IMD sequelae were identified. The literature has evolved, with more types of sequelae reported in more recent studies; however, meningococcal disease-specific and sequelae-specific HRQoL data are lacking, and existing studies used a wide variety of instruments. Physical sequelae included: amputations (up to 8% of children, 3% adolescents/adults) and skin scars (up to 55% of children, 18% adolescents, 2% adults). Neurologic sequelae included: hearing loss (up to 19% of infants, 13% children, 12% adolescents, 8% adults). Psychological sequelae included: anxiety, learning difficulties, emotional and behavioural difficulties. IMD negatively affects HRQoL in patients and also in their family and close caregiver network, both in the short- and long-term. Even IMD survivors without sequelae experienced an adverse impact on HRQoL after many years, affecting self-esteem, physical, mental and psychosocial health, and HRQoL was worse in those with cognitive and behavioural sequelae.

Conclusion: A high proportion of IMD survivors are affected by a broad range of sequelae and reduced HRQoL that persists years after infection. Childhood IMD survivors had more sequelae and more severe sequelae compared with adult survivors. HRQoL was affected in patients and also in their families, caregivers and surrounding network over the long term. More research is needed to resolve data gaps and to standardise HRQoL assessment.

Funding: GlaxoSmithKline Biologicals SA (Rixensart, Belgium).

Keywords: Health-related quality of life; Invasive meningococcal disease; Neisseria meningitidis; Sequelae; Systematic literature review.

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Figures

Fig. 1
Fig. 1
Systematic literature review flow diagram. n number. *includes 20 cost or cost-effectiveness studies, 10 epidemiological studies, and 9 reviews/SR. **indicates studies conducted in low-income countries
Fig. 2
Fig. 2
Number of IMD sequelae reported in observational studies from 2000 to 2016. The numbers on the y axis represent the numbers of each type of sequelae reported; however, it is possible that more than one type of sequela occurred in a subject. *Schmand is a follow-up study of Van de Beek; N total number of subjects in the study
See this image and copyright information in PMC

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