Outcome of pneumococcal meningitis: a retrospective controlled cohort study with economic analysis.
Dr Deborah Christie, Dr Kyle Knox, Dr Russell Viner, Professor E Richard Moxon, Professor Robert Booy
- Start Date:
01 January 2001
St Barts and Royal London School of Medicine and Dentistry, London, UK
Background: Streptococcus pneumoniae remains an important cause of meningitis with significant mortality and morbidity. There are no contemporary data on important functional, educational/vocational, psychological and social outcomes that may have economic consequences. Work is needed to inform cost-benefit analyses necessary for the introduction of pneumococcal conjugate vaccines in the UK.
- To determine the prevalence of educational and employment disadvantage, impaired physical function, social isolation, psychological burden, neuropsychological deficits and reduced quality of life attributable to Streptococcus pneumoniae meningitis (SPM);
- To provide an evidence-base to inform an analysis of cost-effectiveness of the newly licensed pneumococcal vaccine.
Methodology: matched retrospective cohort study; 160 cases drawn from two prospectively collected cohorts of UK children aged 0-14 years at onset of illness (now 1-10 years after SPM), and 160 sibling controls. Outcomes measured through supervised questionnaire and neuropsychological tests. Outcomes: educational attainment, employment status, social function (housing, assessment of dependency, formation of intimate relationships), social support and social capital, quality of life, psychopathology (depression and anxiety and measures of psychiatric caseness), physical and functional disability. Economic data will be gathered in the domains of health, education, social security, and personal/family costs. Acute case fatality rates will be calculated using hospital discharge records and verified using the Oxford Record Linkage Study, Hospital and GP records. The morbidity and mortality attributable to SPM will be determined by calculating the population attributable risk. The economic impact will then be calculated as a population attributable cost.