Risk Factors for Contracting Invasive Meningococcal Disease and Related Mortality: A Systematic Literature Review and Meta-analysis

Objectives: To describe risk factors (RFs) and quantify their effects in invasive meningococcal disease (IMD) and associated mortality across all age groups based on the available published literature. Methods: A systematic literature review (SLR) was conducted via MEDLINE (R) and Embase. Study selection, data extraction, and quality assessment were performed by two independent reviewers. Associations between RFs and outcomes were quantified via a meta-analysis (MA). Results: Seventy-four studies (date range 1950 - 2018) were included in the SLR. Statistically significant RFs for contracting IMD identified from the SLR (within-study) included previous IMD infection and young age (0 - 4 years). MA indicated that significant RFs for contracting IMD (11 studies) were: HIV positive status, passive smoke exposure, and crowded living space. In the MA for IMD-related mortality risk (11 studies), age 25 - 45 years (vs. 0 - 5 years) and serogroup C (vs. serogroup B) were significantly associated with increased risk. Conclusions: Previous findings of higher risk for IMD contraction with smoke exposure and crowded living conditions in children/adolescents have been extended by this SLR/MA to all age groups. We provide strong evidence for higher risk of IMD in HIV-positive individuals, and confirm previous findings of higher IMD-related mortality risk in adults aged 25 - 45. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Automated summary

This study aimed to describe and quantify the risk factors for invasive meningococcal disease (IMD) and associated mortality across all age groups. A systematic literature review (SLR) and meta-analysis (MA) were conducted, and the results showed significant associations between risk factors such as HIV positive status, passive smoke exposure, and crowded living space, and the contraction of IMD. Age and serogroup were also found to be significantly associated with IMD-related mortality risk. These findings provide important evidence for understanding and preventing IMD.