Twelve year outcomes following bacterial meningitis: further evidence for persisting effects

Abstract

AIM To determine whether intellectual and cognitive impairments observed seven years following early childhood bacterial meningitis persist into adolescence. METHODS Blinded neuropsychological, auditory, and behaviour assessments were conducted in 109 (69%) subjects from an original cohort of 158 children, seven and 12 years after their meningitis, and in 96 controls. RESULTS Meningitis subjects remained at greater risk than controls for any disability (odds ratio OR 4.7, confidence interval 2.2 to 9.6). Those with acute neurological complications had more sequelae than children with uncomplicated meningitis or controls (47% v 30%v 11.5% respectively; p < 0.001). Differences in intellectual, academic, and high level cognitive function between subjects and controls were maintained at the seven and 12 year assessments. In contrast, lower order skills improved, while behaviour scores deteriorated significantly (p = 0.033). CONCLUSIONS Many of the deficits identified at the seven year follow up persist 12 years after an episode of bacterial meningitis. Bacterial meningitis in children is associated with substantial excess risk of intellectual, cognitive, and auditory impairment that persists into adolescence Continuing developmental problems of higher order language, organisation, problem solving, and central auditory function may increase learning and behavioural difficulties The risk of these adverse outcomes is greatest in, but not confined to, those who experienced acute neurological complications at the time of their illness Families, schoolteachers, and health professionals have an important role in identifying and/or helping those with learning and behavioural difficulties