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Table 1 Comprehensive IMD sequelae map: selected sequelae proportions (range across studies), and relevance for economic evaluation

From: Range of invasive meningococcal disease sequelae and health economic application – a systematic and clinical review

Category / clinical presentation Sequelae % (range across studies) Relevant for EE Source SIGN
Category: Physical/neurological sequelae
Renal condition 7.32 (0.79–8.92) Yes Huang 2020 [25] 2+
Hearing loss – unilateral/hearing impairment 6.47 (2.30–12.94) Yes Viner 2012 [19] 2++
Non-severe neurological disorders 5.02 (1.26–12.17) Yes Rivero-Calle 2016 [26] 2+
Hearing loss – moderate bilateral 4.74 (3.32–4.74) Yes Viner 2012 [19] 2++
Communication disorders 4.18 (0.39–12.17) Yes Viner 2012 [19] 2++
Motor deficit - composite of: 3.97 Yes  
 Muscle weakness 2.47 (0.26–5.83)   Cabellos 2019 [27] 2+
 Palsy 0.26 (0.26–7.93)   Bettinger 2013 [20] 3
 Movement coordination/ balance deficits 0.22 (0.00–16.83)   Rivero-Calle 2016 [26] 2+
 Other and non-specific motor deficits 1.02 (1.02–12.17)   Bettinger 2013 [20] 3
Skin scarring (with/without grafting) 3.66 (1.67–17.82) Yes Huang 2020 [25] 2+
Hearing loss – severe/profound bilateral (cochlear implant) 2.45 (1.53–11.88) Yes Viner 2012 [19] 2++
Seizures/epilepsy 2.09 (0.92–7.06) Yes Viner 2012 [19] 2++
Other and non-specified skin disease (e.g., skin necrosis, eczema, psoriasis) 1.53 (1.53–2.40) Yes Rivero-Calle 2016 [26] 2+
Amputation 1.26 (major) 2.09 (major and minor) (1.74–3.84) Yes Viner 2012 [19] 2++
Severe neurological disorders 1.02 (1.02–1.18) Yes Bettinger 2013 [20] 3
Mental retardation/low IQ 0.84 (0.52–2.44) Yes Viner 2012 [19] 2++
Blindness/severe visual impairment 0.42 (0.26–2.44) Yes Viner 2012 [19] 2++
Raynaud phenomenon symptoms 27.72   Borg 2009 [28] 2+
Other and non-specified vascular conditions 15.24 (0.26–15.24)   Huang 2020 [25] 2+
Chronic headaches 13.91 (13.91–18.33)   Stein-Zamir 2014 [29] 3
Other and non-specific physical conditions 12.87 (0.92–12.87)   Borg 2009 [28] 2+
Learning disabilities* 11.76   Svendsen 2020 [30] 2+
Pulmonary condition 10.82 (0.13–10.82)   Cabellos 2019 [27] 2+
Arthritis 5.73 (5.73–7.59)   Gottfredson 2011 [18] 2-
Limb deficiency/deformities 3.96 (3.96–8.70)   Borg 2009 [28] 2+
Other and non-specific intellectual disabilities 1.48 (0.63–22.61)   Gottfredson 2011 [18] 2-
Other visual impairments 1.13 (0.92–1.13)   Sadarangani 2015 [31] 2-
Other and non-specified musculoskeletal deficiencies 0.44 (0.44–3.65)   Rivero-Calle 2016 [26] 2+
Other and non-specified abnormal brain activity 0.26   Bettinger 2013 [20] 3
Vegetative state 0.13   Stoof 2015 [21] 3
Category: Psychological/behavioural sequelae
ADHD 11.41 Yes Viner 2012 [19] 2++
Separation anxiety 6.85 Yes Viner 2012 [19] 2++
Generalised anxiety 2.68 (2.68–5.83) Yes Viner 2012 [19] 2++
Depression 0.26 (0.00–5.83) Yes Bettinger 2013 [20] 3
Oppositional defiant disorder 11.41   Viner 2012 [19] 2++
Other and non-specific anxiety disorders 6.67 (0.00–6.67)   Gottfredson 2011 [18] 2-
Conduct disorder 6.04   Viner 2012 [19] 2++
Specific phobias 4.70   Viner 2012 [19] 2++
Other and non-specific emotional/behavioural disorders 3.41   Stoof 2015 [21] 3
Hydrocephalus 2.44   Huang 2020 [25] 2+
Autistic spectrum disorder 1.34   Viner 2012 [19] 2++
Social anxiety disorder/social phobia 1.34   Viner 2012 [19] 2++
Eating disorder 0.68   Viner 2012 [19] 2++
Post-traumatic stress disorder 0.00   Viner 2012 [19] 2++
  1. Note: No range is reported when sequela was from a single study
  2. ADHD Attention-deficit/hyperactivity disorder, EE Economic evaluation, IMD Invasive meningococcal disease, IQ Intelligence quotient, SIGN Scottish Intercollegiate Guidelines Network
  3. aAggregate % reported for: learning disabilities, behavioural problems and memory loss, used as a proxy for ‘learning disabilities’