title: Early neurologic complications and long-term sequelae of childhood bacterial meningitis in a limited-resource country (Kosovo).
abstract: OBJECTIVE
  Since neurologic complications of childhood bacterial meningitis are encountered frequently despite antibiotic treatments, the purpose of this study was to analyze early neurologic complications and long-term sequelae of bacterial meningitis in children in a limited-resource country (Kosovo)
  
  
  METHODS
  This study uses a retrospective chart review of children treated for bacterial meningitis in two study periods: 277 treated during years 1997-2002 and 77 children treated during years 2009-2010.
  
  
  RESULTS
  Of the 277 vs 77 children treated for bacterial meningitis, 60 (22%) vs 33 (43%) patients developed early neurologic complications, while there were 15 (5.4%) vs 2 (2.6%) deaths. The most frequent early neurologic complications were the following: subdural effusions (13 vs 29%), recurrent seizures (11 vs 8%), and hydrocephalus (3 vs 3%). The relative risk (95% confidence interval) for neurologic complications was the highest in infants (3.56 (2.17-5.92) vs 2.69 (1.62-4.59)) and in cases caused by Haemophilus influenzae 1.94 (1.09-3.18) vs Streptococcus pneumoniae 2.57(1.26-4.47). Long-term sequelae were observed in 10 vs 12% of children, predominantly in infants. The most frequent long-term sequelae were late seizures 9 vs 1%, neuropsychological impairment 1 vs 5%, and deafness 1 vs 3%.
  
  
  CONCLUSIONS
  In both study periods, the most frequent early neurologic complications of childhood bacterial meningitis were subdural effusions. Long-term sequelae were observed in 10% of children, with late seizures, neuropsychological impairment, and deafness being the most common one. Age prior to 12 months was risk factor for both early neurologic complications and long-term sequelae of bacterial meningitis in children.
authors.affiliation: Infectious Diseases Clinic, University Clinical Center of Kosovo, University of Prishtina, Hil-Mosi 3A., Prishtina, Kosovo. sadie.namani@yahoo.com
authors.forename: Sadie A
authors.initials: SA
authors.lastname: Namani
authors.forename: Bulëza M
authors.initials: BM
authors.lastname: Koci
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Milenković
authors.forename: Remzie
authors.initials: R
authors.lastname: Koci
authors.forename: Emine
authors.initials: E
authors.lastname: Qehaja-Buçaj
authors.forename: Lindita
authors.initials: L
authors.lastname: Ajazaj
authors.forename: Murat
authors.initials: M
authors.lastname: Mehmeti
authors.forename: Vlora
authors.initials: V
authors.lastname: Ismaili-Jaha
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006295:Health Resources / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology*; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D015022:Yugoslavia / Q000453:epidemiology