An attempt at an epidemiological explanation - Epib.nl

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CHAPTER 5PATIENT AND STRAIN CHARACTERISTICS IN RELATIONTO THE OUTCOME OF MENINGOCOCCAL DISEASEA multivariate analysisRJPM Scholten, HA Bijhner, HA Valkenburg, J DankertSubmitted for publication
Chapter 5ABSTRACfThe aim of this prospective study, conducted in tbe Netherlands from 1989 to 1990,was to investigate the joint association of patient and strain characteristics with theoutcome of meningococcal disease (MD). The study included 563 consecutive cases ofsystemic MD. Patient data were collected by means of a questionnaire. The meningococcalisolates were characterized with regard to their surface characteristics.Sequelae occurred in 8.5% of the patients, and were only associated with thepresence of septicemia. The case-fataUty ratc was 7.7%. In a multivariate analysis,age, gender and tbe clinical presentation (meningitis and/or septicemia) were foundto be the most important determinants for a fata l outcome. Infants aged 55 monthsand patients 10·19 years and 2:50 years of age had an increased risk for a fataloutcome compared witb cbildren from 6 months to 9 years old (Odds Ratios (OR):5.1, 3.4 and 9.S, respectively). The OR for females versus males was 2.3. The risk fora fata l disease outcome was higher for patients with septicemia or a combination ofsepticem ia and meningitis, compared with meningitic patients (ORs 2.3 and 3.1,respectively). Meningococcal strain characteristics did not influence the case-fatalityrate substantially during the study-period. In conclusion, host factors were found tobe determinants for a fatal outcome of MD in the Netherlands from 1989 to 1990.64
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An attempt at an epidemiological ex
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VRIJE UNIVERSITEITTHE INCREASED INC
Page 5 and 6:
CONTENTSChapter 1 General introduct
Page 7 and 8:
Chapter 1Meningococcal disease (MD)
Page 9 and 10:
Chapter 1Antigenic variation in the
Page 11 and 12:
Chapter 1by electrophoretic typing.
Page 13 and 14: Chapter 1is assumed to be the main
Page 15 and 16: CluJpter 1Study objectives and cont
Page 17 and 18: Chapter 125 Crowe BA. Wall RA. Kuse
Page 19 and 20: Chapter 170 Brandtzacg P, Kicrulf P
Page 21 and 22: Chapler 2ABSTRACfIn order to explai
Page 23 and 24: Chapter 2MATERIALS AND METHODSBacte
Page 25 and 26: Chapter 2Table 2. An nual number of
Page 27 and 28: Chapter 2the age-distribution to ol
Page 29 and 30: Chapter 2of serotype 4 strains vari
Page 31 and 32: Chapter 2Table 6. Relative distribu
Page 33 and 34: Chapter 2endemicity in the Netherla
Page 35 and 36: Chapter 2REFERENCESde Marie S. Epid
Page 37 and 38: CHAPTER 3PHENOTYPIC AND GENOTYPIC C
Page 39 and 40: Evolution of meningococcal cionesIN
Page 41 and 42: Evolution of meningococcal clonesme
Page 43 and 44: Evolution of meningococcal clonesTa
Page 45 and 46: Evolution of meningococcal clonesli
Page 47 and 48: CHAPTER 4LIPOOLIGOSACCHARIDE IMMUNO
Page 49 and 50: LOS immunotyping of N. meningitidis
Page 57 and 58: LOS immunolyping of N. meningilidis
Page 59 and 60: LOS immunolyping of N. meningilidis
Page 63: LOS immunotyping of N. meningitidis
Page 67 and 68: Chapter 5tive lung disease, chronic
Page 69 and 70: Chapter 5distribution of the clinic
Page 71 and 72: Chapter 5The striking difference in
Page 73 and 74: Chapter 510-19 and ~50 years, in wh
Page 75 and 76: Chapter 5REFERENCES1 Andersen BM. M
Page 77 and 78: Chapter 6ABSTRACfObjectives: To ass
Page 79 and 80: Chapter 6PATIENTS AND METHODSThis s
Page 81 and 82: Chapler 6case. In 28 household cont
Page 83 and 84: Chapter 6rifampicin witb oral contr
Page 85 and 86: CHAPTER 7GENERAL DISCUSSION ANDRECO
Page 87 and 88: General discussionexample of the ab
Page 89 and 90: General discussionPossible changes
Page 91 and 92: General discussionBrazilian study,
Page 93 and 94: General discussionIt is very diffic
Page 95 and 96: General discussionREFERENCES1 Pelto
Page 97 and 98: SUMMARY
Page 99 and 100: Summaryemergence of a meningococcal
Page 101 and 102: Summaryexplains part of the rise. T
Page 103 and 104: SamenvattingMeningokokkenziekte (me
Page 105 and 106: Samenvatting57 isolaten was bet imm
Page 107 and 108: AFFILIATIONS OF CO-AUTHORSHenk A. B
Page 109 and 110: DaJl /..:woordVele" hebben meegewer
Page 111: DanklVoordMijD ouders dank ik voor
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