Long term sequelae of childhood acute bacterial meningitis in a developing country. A study from the Sudan.
35 survivors of acute bacterial meningitis (ABM) from a group of 44 Sudanese children--seen during 18 months (April 1985-November 1986)--were prospectively followed to ascertain the long-term sequelae of the disease. 30 (17 with Haemophilus influenzae, 8 Neisseria meningitidis, 4 Streptococcus pneumoniae and one child with Enterobacter cloacae meningitis) could be followed during the surveillance period (3-4 years). Three (10%), including 2 with hemiplegia, died after 11-12 months. The association between motor deficit on discharge from hospital and subsequent death was significant (p = 0.04). Of the remaining 27, neuropsychologic sequelae were recorded in 9 (33%). Sensorineural hearing loss was observed in 6 (22%) patients and improved in one during surveillance. Motor deficits were found to improve with time but were replaced by the development of epilepsy about 3 years later in 11% of the survivors. The mean IQ (+/- SD) score for a subgroup of 19 post-meningitic children (92.3 +/- 13.9) was found to be significantly lower than in their nearest-age sibling controls (100.7 +/- 10.2; p = less than 0.01). Younger age at admission and longer duration of ABM symptoms before treatment were significantly associated with poorer outcome (respectively, r = 0.63, p = less than 0.01, r = 0.67, p = less than 0.01). The potential impact of vaccination against the commonest organisms causing ABM in developing countries is discussed.
Salih
M A
MA
Department of Paediatrics, University of Khartoum, Sudan.
Khaleefa
O H
OH
Bushara
M
M
Taha
Z B
ZB
Musa
Z A
ZA
Kamil
I
I
Hofvander
Y
Y
Olcén
P
P
D000208:Acute Disease; D003638:Deafness / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008581:Meningitis / Q000150:complications*; D008583:Meningitis, Haemophilus / Q000150:complications; D008585:Meningitis, Meningococcal / Q000150:complications; D008586:Meningitis, Pneumococcal / Q000150:complications; D009046:Motor Neurons; D011446:Prospective Studies; D011594:Psychometrics; D013397:Sudan; D013997:Time Factors