Neiserria meningitidis remains an important cause of morbidity and mortality in South Africa (SA). It is the sixth commonest cause of notified disease with a case fatality rate of 11% for the period 1990 1994. Identification of preventable risk factors is critical as no effective vaccine exists for serogroup B, the most prevalent serogroup in SA. A case control study was undertaken to determine the risk factors associated with meningococcal disease. The study population consisted of all children under the age of 14 years who were residents of the Cape Town City Council and Cape Metropolitan Council areas of jurisdiction. Cases were identified from weekly notification reports and from admissions to the City Hospital for Infectious Diseases. Controls were selected from the trauma wards at Red Cross War Memorial Children's Hospital. Data was analyzed using EPI INFO and SAS statistical software. During the period October 1993 to January 1995 70 cases and 210 controls were interviewed. Cases were significantly younger than controls (p = 0.0001). On univariate analysis significant risk factors for meningococcal disease included: a household where 2 or more members smoked (odds ratio (OR) =1.8), recent upper respiratory tract infection (OR= 1.8), poor nutritional status (OR= 3.6), being breastfed for less than 3 months (OR= 2.7) and overcrowding (OR= 2.8). After adjusting for confounders, the main force of passive smoking as a risk factor for meningococcal disease appeared to be in the presence of a recent upper respiratory tract infection. Other factors that remained significant after adjusting for confounders included: being breastfed for less than three months (adjusted OR= 2.4) and being less than 4 years old (adjusted OR= 2.3). This is the first case control study in South Africa examining risk factors associated with meningococcal disease. The study provides further evidence for the reduction of smoking, reduction of overcrowding and the promotion of breast-feeding as important public health measures. It also identifies children under the age of 4 years as an important target group should an effective vaccine become available.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/27008 |
| Date | January 1997 |
| Creators | Moodley, Jennifer R |
| Contributors | Coetzee, Nicol, Hussey, Gregory D |
| Publisher | University of Cape Town, Faculty of Health Sciences, Department of Public Health and Family Medicine |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MMed |
| Format | application/pdf |
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