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Cited by 131Bacterial Infections and VaccinesPneumonia and Respiratory InfectionsNeonatal and Maternal Infections

Hospital admission rates for meningitis and septicaemia caused by Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae in children in England over five decades: a population-based observational study

Martin, Natalie G, Sadarangani, Manish, Pollard, Andrew J, Goldacre, Michael J·2014·The Lancet Infectious Diseases
DOI 10.1016/s1473-3099(14)70027-1
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Abstract

Background Infection with Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae causes substantial mortality and long-term morbidity in children. We know of no study to assess the long-term trends in hospital admission rates for meningitis and septicaemia caused by these pathogens in children in England. We aimed to do such a study using routinely reported data in England.Methods In this population-based observational study, we used datasets that include routinely collected administrative statistics for hospital care: the Hospital In-Patient Enquiry (data for England from 1968 to 1985), the Hospital Episode Statistics dataset (data for England from 1989 onwards), and the Oxford record linkage study (data for Oxfordshire and surrounding areas from 1963 to 2011). We analysed annual age-specific and age-standardised admission rates in children younger than 15 years with H influenzae, meningococcal and pneumococcal meningitis, and septicaemia.Findings We saw a reduction in hospital admission rates for childhood invasive bacterial disease after the introduction of conjugate vaccines against H influenzae, N meningitidis, and S pneumoniae in England. Annual incidence of H influenzae meningitis per 100,000 children decreased from 6·72 admissions (95% CI 6·18-7·26) in 1992 to 0·39 admissions (0·26-0·52) in 1994, after the introduction of routine H influenzae type b vaccination. We saw a small rise in admissions in the early 2000s, peaking at 1·24 admissions per 100,000 children (0·99-1·48) in 2003, which decreased to 0·28 per 100,000 children (0·17-0·39) by 2008 after the introduction of catch-up (2003) and routine (2006) booster programmes for young children. Meningococcal disease increased during the 1990s, reaching a peak in 1999, with 34·54 admissions (33·30-35·78) per 100,000 children. Hospital admissions decreased after the meningococcal serogroup C vaccine was introduced in 1999 and was 12·40 admissions (11·68-13·12) per 100,000 in 2011. Admissions for invasive pneumococcal disease increased from the 1990s reaching a peak in 2006 at 4·45 admissions for meningitis (95% CI 4·0-4·9) per 100,000 children and 2·81 admissions for septicaemia (2·45-3·17) per 100,000 children. A reduction in admissions occurred after the introduction of the pneumococcal conjugate vaccine in 2006: hospital admission rates in 2011 were 2·03 per 100,000 children for meningitis and 1·12 per 100,000 children for septicaemia.Interpretation Vaccine-preventable invasive bacterial disease in children has decreased substantially in England in the past five decades, most notably with the advent of effective conjugate vaccines since the 1990s. Ongoing disease surveillance and continued development and implementation of vaccines against additional pneumococcal serotypes and serogroup B meningococcal disease are important.Funding None.

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Crossref · 10.1016/s1473-3099(14)70027-1

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  • Vaccines targeted against N. meningitidis serogroups A or C, or a tetravalent A, C, Y, and W135 vaccine have been incorporated into vaccine programs in many countries and have led to a documented decrease in cases due to these serogroups.

    “Vaccines targeted against N. meningitidis serogroups A or C, or a tetravalent A, C, Y, and W135 vaccine have been incorporated into vaccine programs in many countries over recent years, and have led to a documented decrease in cases due to these serogroups. [11, 12]”

    From Global etiology of bacterial meningitis: A systematic review and meta-analysis. (2018) · cites this paper as [11]

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Authors
Martin, N. G., Sadarangani, M., Pollard, A. J., & Goldacre, M. J.
Affiliations
University of Oxford (GB)
Corresponding author
Martin, Natalie G
ORCID
Venue
The Lancet Infectious Diseases
Publisher
Elsevier BV
Published
2014-05
Volume
14
Issue
5
Pages
397-405
ISSN
1473-3099 (ISSN-L)
DOI
10.1016/s1473-3099(14)70027-1
OpenAlex
W2007545021
Cited by
131
References
39
Citations by year
2026: 5 · 2025: 6 · 2024: 8 · 2023: 4 · 2022: 6 · 2021: 12 · 2020: 4 · 2019: 13 · 2018: 14 · 2017: 14 · 2016: 12 · 2015: 21 · 2014: 11
FWCI
15.74
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Lancet Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
English National Institute for Health Research (grant number RNC/035/002)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
Keywords
septicemia, hospitalization rates, conjugate vaccines, Haemophilus influenzae type b vaccine, meningococcal conjugate vaccine, pneumococcal conjugate vaccine, vaccine impact, temporal trends
MeSH terms
Adolescent, Child, Child, Preschool, England, Female, Haemophilus influenzae, Hospitalization, Humans, Infant, Male, Meningitis, Haemophilus, Meningitis, Meningococcal, Meningitis, Pneumococcal, Neisseria meningitidis, Streptococcus pneumoniae, Incidence, Bacteremia

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