A Case-Control Study on the Risk Factors for Meningococcal Disease among Children in Greece.

Christos Hadjichristodoulou,Vassiliki Syriopoulou,Kalliopi Theodoridou,Vasiliki Vasilopoulou,George Mpalaouras,Maria Theodoridou,Georgia Tzanakaki,Antonios Katsioulis,George Rachiotis,Daniela Flavia Hozbor

doi:10.1371/journal.pone.0158524

Abstract

PurposeThe aim of this study was to identify environmental or genetic risk factors that are associated with invasive meningococcal disease (IMD) in children in Greece.MethodsA case-control study was performed in 133 children (44 cases and 89 controls) aged between 0–14 years, who were hospitalized in a children's hospital in Athens. Demographics and possible risk factors were collected by the use of a structured questionnaire. To investigate the association of mannose binding lectin (MBL) with IMD, a frequency analysis of the haplotypes of the MBL2 gene and quantitative measurement of MBL serum protein levels were performed using Nanogen NanoChipR 400 technology and immuno-enzyme techniques, respectively.ResultsThe multivariate analysis revealed that changes in a child's life setting (relocation or vacation, OR = 7.16), paternal smoking (OR = 4.51), upper respiratory tract infection within the previous month (OR = 3.04) and the density of people in the house/100m2 (OR = 3.16), were independent risk factors associated with IMD. Overall 18.8% of patients had a MBL2 genotype with low functionality compared to 10.1% of healthy controls, but this was not statistically significant (p = 0.189).ConclusionPrevention strategies aimed at reducing parental smoking and other risk factors identified in this study could decrease the risk of IMD among children in Greece.

Highlights

The multivariate analysis revealed that changes in a child's life setting, paternal smoking (OR = 4.51), upper respiratory tract infection within the previous month (OR = 3.04) and the density of people in the house/100m2 (OR = 3.16), were independent risk factors associated with Invasive meningococcal disease (IMD)
Overall 18.8% of patients had a MBL2 genotype with low functionality compared to 10.1% of healthy controls, but this was not statistically significant (p = 0.189)
Prevention strategies aimed at reducing parental smoking and other risk factors identified in this study could decrease the risk of IMD among children in Greece

Summary

Introduction

Invasive meningococcal disease (IMD) is a contagious bacterial disease caused by a meningococcus (Neisseria meningitidis), a Gram-negative bacterium that is classified into 13 capsular groups according to its capsular polysaccharides. Six of these (A, B, C, Y, X and W), are of clinical significance as they cause invasive infections. In the USA, groups B, C and Y cause a high proportion of IMD [2], while in Africa group A is predominant and groups W, X and C are endemic [3]. IMD has a high fatality rate and many survivors develop permanent sequelae [4,5]

Objectives

Methods

Conclusion