Sujet
Complement deficiency, melanesian population, meningococcal disease, risk factors, MESH: Adolescent, MESH: Adult, MESH: New Caledonia, MESH: Retrospective Studies, MESH: Aged, MESH: Risk Factors, MESH: Young Adult, MESH: Aged, 80 and over, MESH: Bacteremia, MESH: Child, MESH: Child, Preschool, MESH: Complement System Proteins, MESH: Infant, MESH: Female, MESH: Humans, MESH: Male, MESH: Meningitis, Meningococcal, MESH: Meningococcal Infections, MESH: Middle Aged, MESH: Neisseria meningitidis, Serogroup B, MESH: Neisseria meningitidis, Serogroup W-135, MESH: Neisseria meningitidis, Serogroup Y, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases

Domaines
Santé, Foncier, Environnement, Sciences exactes

Description
International audience


PurposeInvasive Meningococcal Disease (IMD) is three fold more common in New Caledonia (NC) than in metropolitan France and many IMD cases (35.7 %) are due to Y and W135 serogroups. The purpose of our study was to identify IMD risk factors in NC.MethodsA retrospective study of all IMD cases that occurred in NC between 2005 and 2011 was conducted. Socio-environmental, clinical and biological data were collected. A search for immune deficiency was proposed to all cases. IMD presentation and outcome were compared according to meningoccal serogroups and the complement deficiency status (C-deficiency).ResultsSixty-six sporadic IMD cases (29 B serogroup, 20 Y or W135, 6 C, 1 A, 10 unknown) occurred in 64 patients often <24 years-old and of Melanesian origin. Five patients died (7.8 %). No socio-environmental risk factors were identified. No asplenia, HIV infection or immunoglobulin deficiencies were found. Two patients had diabetes and 28 of 53 (52.8 %) patients had C-deficiency including 20 (71.4 %) cases of late complement component deficiency. Patients with C-deficiency were mainly Melanesian (92.8 %) originating from the Loyalty Islands (62.1 %). They were mostly infected with Y/W135 (42.9 %) or B serogroups (32.1 %). They often developed later and more severe disease than patients without C-deficiency (need for intensive cares in 60 % versus 28.0 % of cases, p = 0.01).ConclusionsA high prevalence of C-deficiency in the Melanesian population may explain epidemiological and clinical features of IMD in NC. Our results imply an adaptation of meningococcal vaccine strategies in NC.

Mots-clés
Environment

Langue
English (en-GB)

Auteurs
Daures, Maguy, John, Michele, Balter, Cécile Veysseyre, Simon, Olivier, Barguil, Yann, Missotte, Isabelle, Grangeon, Jean-Paul, Laumond-Barny, Sylvie, Noel, Martine, Besson-Leaud, Laurent, Spasic, Pierre-Emmanuel, de Suremain, Aurélie, Gourinat, Ann-Claire, Descloux, Elodie

Contributeurs
Direction des Affaires sanitaires et sociales de la Nouvelle-Calédonie [Nouméa] (DASS [Nouméa]), Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon, Centre hospitalier territorial Gaston-Bourret [Dumbea] (CHT) ; Centre hospitalier territorial Gaston-Bourret [Nouméa], Institut Pasteur de Nouvelle-Calédonie ; Réseau International des Instituts Pasteur (RIIP), This work was supported by the New Caledonia Health Department.

Sources
ISSN: 0271-9142, EISSN: 1573-2592, Journal of Clinical Immunology, https://hal.archives-ouvertes.fr/hal-03423240, Journal of Clinical Immunology, Springer Verlag, 2015, 35 (1), pp.47-55. ⟨10.1007/s10875-014-0104-6⟩

Relation
info:eu-repo/semantics/altIdentifier/doi/10.1007/s10875-014-0104-6
info:eu-repo/semantics/altIdentifier/pmid/25352052

Couverture
Melanesia

Nom du journal