Hearing loss at school age in survivors of bacterial meningitis: assessment, incidence, and prediction.
OBJECTIVE
To establish the incidence of sensorineural hearing loss in children who survived non-Haemophilus influenzae type B (Hib) bacterial meningitis, to highlight the actual percentage whose hearing was evaluated, and to develop a prediction rule to identify those who are at risk of hearing loss.


METHODS
In 1999, we compiled a cohort of 628 school-aged children who were born between January 1986 and December 1994 and had survived non-Hib bacterial meningitis between January 1990 and December 1995. Presence of sensorineural hearing loss (>25 dB) was determined, based on information from questionnaires and medical records. Potential risk factors for hearing loss were obtained from medical records; independent predictors were identified using multivariate logistic regression analysis, leading to the formulation of a prediction rule.


RESULTS
The incidence of hearing loss was 7%. The hearing of 68% of the children was evaluated as part of their routine follow-up after bacterial meningitis, resulting in the detection of 75% of the cases of hearing loss. The remaining 25% were detected after this follow-up had ended. Using a prediction rule based on 5 factors-duration of symptoms before admission >2 days, absence of petechiae, cerebrospinal fluid glucose level <or=0.6 mmol/L, Streptococcus pneumoniae, and ataxia-62% of the postmeningitic children were selected as being at risk. All cases of hearing loss were in this at-risk group.


CONCLUSIONS
Hearing loss can be predicted satisfactorily. When the hearing of children who are predicted to be at risk is tested as part of their routine follow-up, no children with hearing loss need be missed.
Department of Pediatrics, VU Medical Center, Amsterdam, the Netherlands.
Irene
I
Koomen
Diederick E
DE
Grobbee
John J
JJ
Roord
Rogier
R
Donders
Aag
A
Jennekens-Schinkel
A M
AM
van Furth
D000293:Adolescent; D001259:Ataxia / Q000453:epidemiology / Q000209:etiology; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000134:cerebrospinal fluid; D006312:Hearing Loss, Bilateral / Q000453:epidemiology / Q000209:etiology; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications*; D009426:Netherlands / Q000453:epidemiology; D011693:Purpura / Q000453:epidemiology; D012307:Risk Factors; D017741:Survivors
D005947:Glucose