title: Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis.
abstract: OBJECTIVE
  To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood.
  
  
  OBJECTIVE
  To study educational achievement and economic self-sufficiency in adults diagnosed as having bacterial meningitis in childhood.
  
  
  METHODS
  Nationwide population-based cohort study using national registries of Danish-born children diagnosed as having meningococcal, pneumococcal, or Haemophilus influenzae meningitis in the period 1977-2007 (n=2784 patients). Comparison cohorts from the same population individually matched on age and sex were identified, as were siblings of all study participants. End of study period was 2010.
  
  
  METHODS
  Cumulative incidences of completed vocational education, high school education, higher education, time to first full year of economic self-sufficiency, and receipt of disability pension and differences in these outcomes at age 35 years among meningitis patients, comparison cohorts, and siblings.
  
  
  RESULTS
  By age 35 years, among persons who had a history of childhood meningococcal (n=1338), pneumococcal (n=455), and H. influenzae (n=991) meningitis, an estimated 11.0% (41.5% vs 52.5%; 95% CI, 7.3%-14.7%), 10.2% (42.6% vs 52.8%; 95% CI, 3.8%-16.6%), and 5.5% (47.7% vs 53.2%; 95% CI, 1.9%-9.1%) fewer persons, respectively, had completed high school and 7.9% (29.3% vs 37.2%; 95% CI, 1.6%-14.2%), 8.9% (28.1% vs 37.0%; 95% CI, 0.6%-17.2%), and 6.5% (33.5% vs 40.0%; 95% CI, 1.4%-11.6%) fewer had attained a higher education compared with individuals from the comparison cohort. Siblings of meningococcal meningitis patients also had lower educational achievements, while educational achievements of siblings of pneumococcal and H. influenzae meningitis patients did not differ substantially from those in the general population. At end of follow-up, 3.8% (90.3% vs 94.1%; 95% CI, 1.1%-6.5%), 10.6% (84.0% vs 94.6%; 95% CI, 5.1%-16.1%), and 4.3% (90.6% vs 94.9%; 95% CI, 2.0%-6.6%) fewer meningococcal, pneumococcal, and H. influenzae meningitis patients were economically self-sufficient and 1.5% (3.7% vs 2.3%; 95% CI, -0.2% to 3.2%), 8.7% (10.0% vs 1.3%; 95% CI, 5.0%-12.4%), and 3.7% (6.2% vs 2.5%; 95% CI, 1.6%-5.8%) more received disability pension compared with individuals from the comparison cohort.
  
  
  CONCLUSIONS
  In a Danish population, bacterial meningitis in childhood was associated with lower educational achievement and economic self-sufficiency in adult life. This association may apply particularly to pneumococcal and H. influenzae meningitis, whereas for meningococcal meningitis the lower educational achievement may be family-related.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, DK2100 Copenhagen, Denmark. casper.roed@rh.regionh.dk
authors.forename: Casper
authors.initials: C
authors.lastname: Roed
authors.forename: Lars Haukali
authors.initials: LH
authors.lastname: Omland
authors.forename: Peter
authors.initials: P
authors.lastname: Skinhoj
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Rothman
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sorensen
authors.forename: Niels
authors.initials: N
authors.lastname: Obel
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006233:Persons with Disabilities; D004522:Educational Status; D005195:Family Relations; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008583:Meningitis, Haemophilus / Q000503:physiopathology*; D008585:Meningitis, Meningococcal / Q000503:physiopathology*; D008586:Meningitis, Pneumococcal / Q000503:physiopathology*; D012042:Registries / Q000706:statistics & numerical data; D035781:Siblings; D012923:Social Class; D017741:Survivors