Initial Experiences with Invasive Meningococcal Disease: Insights from Survivors and Their Caregivers.

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Infectious Diseases and Therapy Pub Date : 2024-12-01 Epub Date: 2024-10-29 DOI:10.1007/s40121-024-01061-7
Oscar Herrera-Restrepo, Nuzhat Afroz, Eliazar Sabater Cabrera, Matthew Reaney, France Ginchereau Sowell, Ramiya Kumar, Alicia Stillman, Patti Wukovits, Mariana Rodrigues, Sofia B Pinto, Zeki Kocaata, Obinna Onwude
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Abstract

Introduction: Invasive meningococcal disease (IMD) has a low incidence but is a life-threatening illness with a 10-15% mortality rate. Even with timely treatment, survivors may experience acute and long-term health complications. While meningococcal vaccines are recommended for adolescents and young adults in the USA, vaccination coverage remains uneven across serotypes. This study investigated the physical, social, psychological, and economic burden of IMD on survivors and their caregivers in the USA during the acute phase (Part 1, presented in this manuscript) and the long-term phase (Part 2, presented in a separate manuscript) of IMD.

Methods: This study implemented a non-interventional, mixed-methods approach using a bespoke survey and qualitative interviews (designed on the basis of a preliminary conceptual model of IMD) with US survivors and their caregivers.

Results: A total of 11 survivors (1 adolescent, 10 adults) and 3 caregivers participated in the study. Survivors contracted IMD during infancy (n = 2), childhood (n = 3), or adulthood (n = 6), and often described leading healthy lives pre-IMD. At IMD onset, interactions with the healthcare system impacted participants' experiences; confusion and care delays were common, and procedures were often invasive (e.g., amputations). Survivors commonly experienced symptoms including skin rash (7/11), fever (6/11), and unconsciousness (6/11), consistent with caregivers' reports. Survivors able to report on the short-term impacts of IMD (n = 9) described functional limitations (9/9), emotional impacts (6/9) such as fear and trauma, and school (6/9), work (4/9), and financial (5/9) challenges. Caregivers also experienced emotional impacts (3/3) and family (2/3), work (3/3), and financial (3/3) impacts during the acute phase.

Conclusions: IMD places a significant humanistic burden on survivors and their caregivers during the acute phase. Results from Part 1 of this study indicate a need for increased disease awareness and healthcare provider education, expeditious diagnosis, and improved access to prevention methods such as available meningococcal vaccines. A video abstract is available with this article. Video abstract (MP4 1,24,432 kb).

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侵袭性脑膜炎球菌病的最初经历:幸存者及其护理人员的见解。
导言:侵袭性脑膜炎球菌病(IMD)发病率很低,但却是一种威胁生命的疾病,死亡率高达 10-15%。即使得到及时治疗,幸存者也可能出现急性和长期并发症。虽然美国建议青少年和年轻成年人接种脑膜炎球菌疫苗,但不同血清型的疫苗接种率仍不均衡。本研究调查了 IMD 在急性期(第 1 部分,在本手稿中介绍)和长期期(第 2 部分,在另一篇手稿中介绍)给美国幸存者及其护理者造成的身体、社会、心理和经济负担:本研究采用了一种非干预性的混合方法,对美国幸存者及其照顾者进行了定制调查和定性访谈(根据 IMD 的初步概念模型设计):共有 11 名幸存者(1 名青少年、10 名成人)和 3 名照顾者参与了研究。幸存者分别在婴儿期(2 人)、童年期(3 人)或成年期(6 人)患上 IMD,他们通常描述了 IMD 前的健康生活。在 IMD 发病时,与医疗系统的互动影响了参与者的经历;困惑和护理延误很常见,而且手术通常是侵入性的(如截肢)。幸存者通常会出现皮疹(7/11)、发烧(6/11)和昏迷(6/11)等症状,这与护理人员的报告一致。能够报告 IMD 短期影响的幸存者(n = 9)描述了功能限制(9/9)、恐惧和创伤等情绪影响(6/9)以及学业(6/9)、工作(4/9)和经济(5/9)方面的挑战。照顾者在急性期也经历了情绪影响(3/3)以及家庭(2/3)、工作(3/3)和经济(3/3)方面的影响:IMD 在急性期给幸存者及其照顾者带来了巨大的人文负担。本研究第一部分的结果表明,有必要提高对疾病的认识,加强对医疗保健提供者的教育,加快诊断,并改进预防方法,如可用的脑膜炎球菌疫苗。本文附有视频摘要。视频摘要(MP4 1,24,432 kb)。
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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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