A 2019/2020 Summer Studentship research project
These studies will help inform clinical practise, the national vaccination programme and future research priorities, and ultimately improve the care of children presenting to hospital with suspected central nervous system infections. This research will also improve understanding of ethnic disparities in disease.
Student: Michelia McBride
Supervisors: Dr Natalie Martin, Paediatrician, Dr Jonathan Williman, Statistician
Sponsor: Canterbury Medical Research Foundation
Although most meningitis nowadays is caused by viruses, little is known about how much viral meningitis there is in New Zealand or outcomes following viral meningitis. In this study, rates of non-bacterial (aseptic) meningitis of different causes in NZ children since 1991 will be assessed. We have previously published studies demonstrating the reduction in bacterial meningitis which occurred in New Zealand and the UK following the introduction of different effective vaccine programmes, and an apparent recent increased incidence of viral meningitis in infants in the UK. The epidemiology of viral and aseptic meningitis in New Zealand (NZ) children has not previously been established, apart from specific reports of enteroviral disease outbreaks. We are also doing related research into outcomes following viral meningitis in New Zealand children.
The aim of this study is to define the epidemiology of viral and aseptic meningitis in New Zealand children since 1991 by creating a national cohort of meningitis cases.
A retrospective national cohort will be developed including children aged less than 15 years admitted to hospital with non-bacterial (aseptic) meningitis since 1991. Data about hospital admissions for non-bacterial meningitis will be obtained from the Integrated Data Infrastructure (IDI) at Statistics New Zealand. The IDI data allows many different national datasets including health data to be linked for the same patient by NHI number. The cases will be identified by ICD coding in the hospital discharge dataset (called NMDS data). Non-admitted cases (emergency department visits) can also be analysed. Cases identified can also be linked to other datasets including the National Immunisation Register, mortality data and geographic data. Rates of viral and aseptic meningitis will be analysed by different aetiologies and pathogens, for example enteroviral meningitis, HSV meningitis, parechoviral meningitis, meningitis with no identified cause, meningitis with a known non-infectious cause. Cases will also be analysed in age groups (age specific and age standardised). Laboratory confirmed viral meningitis cases will also be analysed from the Institute of Science and Research Ltd. A subset analysis will be performed for Māori and non-Māori children.
Student researcher’s component of the study
We already have access to the IDI datasets at StatsNZ and we have ethical approval. Your role will be analyzing data with supervision and preparing a manuscript for submission to a paediatric journal. You may need to spend some time in the data lab at StatsNZ. You will also have the opportunity to work with collaborators from Starship Hospital and from overseas in this study.
Medical student. If you are keen to learn some statistics that would be helpful.