Perfil epidemiológico da doença meningocócica, no estado de Minas Gerais, entre 2000 e 2009.

Abstract

The infection by Neisseria meningitis, named meningococcal disease (MD), can cause meningococcal meningitis and septicemia with or without meningitis. MD is an endemic disease in Brazil, however, has a high potential to cause epidemics and high case fatality which require immediate notification of the cases. The aims of this study were to describe an epidemiological profile using data on notified and confirmed cases of MD in the State of Minas Gerais (MG) from January 2000 to December 2009, obtained at SINAN (Information System for Disease Notification); to calculate the incidence and mortality rates and case fatality by year, age group and sex; to analyze the tendency of MD incidence, mortality and case fatality in MG; to evaluate MD cases proportional distribution by N. meningitidis serogrup by age group and sex and to estimate MD cases among unspecified meningitis. This is a retrospective, descriptive, population based study and type of time series of the epidemiological situation of MD in three regions of MG: Centro, Norte and Triangulo Mineiro (TM) from 2000 to 2009. There were about 168.8 cases per year, the average incidence was 0.88 cases/100.000 inhabitants per year, the average annual case fatality of 25.8% and an mortality average of 45.2 deaths/100.000 inhabitants per year. The highest incidence and mortality by N. meningitidis occurred in children under 1 year of age. The highest fatality occurred in the 60 year old and above age group. In MG, 45.5% of cases lived in the Centro, Norte and TM. The highest frequencies were the 1 to 4 years age group (26.3%), male (54.7%), white (36.4%) and lived in urban area (80.0%). In the cases with specified education, 650 (60.92%) had high school education. The cases in Centro, Norte and TM did not have important differences compared to the epidemiological profile of cases in MG. A minority of cases had received polysaccharide vaccines A (0.4%), C (0.7%), A/C (0.1%) e B/C (2.1%) and meningococcal C conjugate vaccine (0.1%) and all these cases developed MD. Chemoprophylaxis was given to close contacts of 68.9% cases. Serogrouping of meningococci has been done in 500 cases by age and sex. There were 285 (57.0%) cases of serogroup C, of which 72 (23.5%) were in the 1 to 4 years age group and 168 (59.0%) were males. There were 1161 (68.8%) patients discharged and 452 (26.8%) deaths. The tendency of incidence of MD had a slight decline from 2001 to 2007 and a slight acceleration from 2007 to 2009. The mortality rates experienced fluctuations since 2001. It had an abrupt decline between 2006 and 2007 and after that increased again. MD case fatality had non-constant and non-linear decrease over time. 529 cases of MD were estimated among the most unspecified meningitis, using the same proportion of cases of MD (23.05%) among specified bacterial meningitis. In conclusion, most cases of MD were male, white, in the 1 to 4 years age group and lived in urban area. The incidence had slight fall from 2001 to 2007 and from 2007 to 2009 had a slight acceleration.