Open Access Highly Accessed Research article

Incidence of bacterial meningitis (2001–2005) in Lazio, Italy: the results of a integrated surveillance system

Paolo Giorgi Rossi1*, Jessica Mantovani1, Eliana Ferroni1, Antonio Forcina2, Elena Stanghellini2, Filippo Curtale1 and Piero Borgia1

Author Affiliations

1 Agency for Public Health, Lazio Region, Rome, Italy

2 Dipartimento di Economia Finanza e Statistica, University of Perugia, Perugia, Italy

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BMC Infectious Diseases 2009, 9:13  doi:10.1186/1471-2334-9-13

Published: 5 February 2009

Abstract

Background

Monitoring the incidence of bacterial meningitis is important to plan and evaluate preventive polices. The study's aim was to estimate the incidence of bacterial meningitis by aetiological agent in the period 2001–2005, in Lazio Italy (5.3 mln inhabitants).

Methods

Data collected from four sources – hospital surveillance of bacterial meningitis, laboratory information system, the mandatory infectious diseases notifications, and hospital information system – were combined into a single archive.

Results

944 cases were reported, 89% were classified as community acquired. S. pneumoniae was the most frequent aetiological agent in Lazio, followed by N. meningitis. Incidence of H. influenzae decreased during the period. 17% of the cases had an unknown aetiology and 13% unspecified bacteria. The overall incidence was 3.7/100,000. Children under 1 year were most affected (50.3/100.000), followed by 1–4 year olds (12.5/100,000). The percentage of meningitis due to aetiological agents included in the vaccine targets, not considering age, is 31%. Streptococcus spp. was the primary cause of meningitis in the first three months of life. The capture-recapture model estimated underreporting at 17.2% of the overall incidence.

Conclusion

Vaccine policies should be planned and monitored based on these results. The integrated surveillance system allowed us to observe a drop in H. influenzae b meningitis incidence consequent to the implementation of a mass vaccination of newborns.