Juan Francisco Falconi

Background: Around 30% of survivors of invasive meningococcal disease (IMD) may develop long-term sequelae; data from Latin America remain scarce. This study aimed to estimate the proportion of long-term sequelae in pediatric IMD survivors and associated factors. Methods: A retrospective cohort study with cross-sectional outcome evaluation included children diagnosed with IMD (2009–2019) in 2 hospitals in Santiago, Chile. Between October 2022 and April 2023, 40 IMD survivors and 42 age- and sex-matched children without IMD or central nervous system infection underwent standardized physical, neurocognitive, audiologic and functional assessments conducted independently. Prevalence ratio (PR) and adjusted PR (aPR) were estimated with modified Poisson regression with standard errors. Results: Median ages were 10 (interquartile range [IQR] 9–13) and 11 (IQR 9–14) years in the exposed and unexposed groups; 70% and 64.3% were male. Sequelae occurred in 70% of exposed; the corresponding clinical findings were present in 16.7% of unexposed children (PR, 4.20; 95% confidence interval [CI]: 2.07–8.51). Neurologic (55%), dermatologic (25.0%) and hearing (20.5%) sequelae predominated. This association remained significant after adjusting for age, sex, caregiver education and socioeconomic status (aPR, 3.75; 95% CI: 1.83–7.69). Children with sequelae had a lower quality of life than those without sequelae (62% and 8%, P = 0.004). Conclusion: Pediatric survivors of IMD in Chile face a high burden of long-term sequelae. Sustained multidisciplinary follow-up and preventive strategies, including vaccination, are essential to reduce disability and improve quality of life.

Background: During the COVID-19 pandemic, reductions in cases of bacterial diseases transmitted via the respiratory route were reported by the Invasive Respiratory Infection Surveillance Consortium. Here, we evaluate the epidemiology of invasive meningococcal disease (IMD) in Argentina, Brazil, Chile, and Colombia during and after the COVID-19 pandemic. Methods: The epidemiology of meningococcal disease was reviewed in selected South American countries through 2023 from publicly available national surveillance system databases. Results: The incidence of IMD decreased substantially in 2020 in Argentina, Brazil, Chile, and Colombia and was followed by a trend of increased disease. Similarly to observations in several European countries, the post-pandemic rebounds in cases of IMD in the four South American countries included in this analysis were mainly caused by serogroup B, that became one of the predominant serogroups causing IMD in all four countries. Conclusions: Enhanced surveillance of IMD, including genomic characterization of strains, is needed to inform public health policymakers and guide future vaccination strategies in the region.