Long Term Follow-Up of Estonian Children After Bacterial Meningitis

Lutsar, Irja; Siirde, Toomas; Soopõld, T

doi:10.1097/00006454-199507000-00014

Cited by 13 publications

(24 citation statements)

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“…Most of the risk factors found in our study have been reported previously (2,6,7,9,11,(13)(14)(15). However, these authors all studied death or severe sequelae simultaneously with academic and/or behavioural limitations as outcome, and none of these studies provided a prediction rule to detect children at high risk for these limitations (2,6,7,9,11,(13)(14)(15).…”

Section: Discussionmentioning

confidence: 61%

“…In about 15% of the children who survive bacterial meningitis, severe sequelae such as sensorineural hearing loss, motor problems, seizures and mental retardation occur (2)(3)(4)(5)(6)(7)(8).…”

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confidence: 99%

“…More subtle adverse outcomes such as cognitive, academic and behavioural problems are present in over 20% (4)(5)(6)(7)(9)(10)(11)(12)(13). These problems often remain undetected until the children start school, several years after they have been cured of their meningitis.…”

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confidence: 99%

“…Several risk factors for severe and more subtle sequelae after bacterial meningitis have been proposed, including male gender, young age at illness, acute-phase neurological complications and S. pneumoniae as the infective pathogen (2,6,7,9,11,(13)(14)(15). However, academic and/or behavioural problems were not specifically addressed and none of the reports provided comprehensive prediction rules, which could be used in practice to detect children at high risk.…”

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confidence: 99%

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Prediction of academic and behavioural limitations in school‐age survivors of bacterial meningitis

Koomen

Grobbee²,

Roord

et al. 2004

Acta Paediatrica

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Aim: To develop a prediction rule to identify postmeningitic children at high risk of academic and behavioural limitations. Methods: 182 children (mean age 10 y; range 5-14) were selected from a cohort of 674 school-age survivors of bacterial meningitis. These children had neither meningitis with "complex onset", nor prior cognitive or behavioural problems, nor severe disease sequelae. On average, 7 y after the meningitis, they were evaluated using an "Academic Achievement Test", and their parents filled in the "Child Behaviour Checklist". By reviewing the medical records, potential risk factors for academic and/or behavioural limitations were collected. Independent predictors were identified using multivariate logistic regression analysis, leading to the formulation of a prediction rule. Results: The cumulative incidence of academic and/or behavioural limitations among children who survived bacterial meningitis without severe disease sequelae was 32%. The prediction rule was based on nine independent risk factors: gender, birthweight, educational level of the father, S. pneumoniae, cerebrospinal fluid leukocyte count, delay between admission and start of antibiotics, dexamethasone use, seizures treated with anticonvulsive therapy, and prolonged fever. When 10 was taken as a cut-off point for the risk score computed using this rule, 76% of the children with limitations could be identified, while 38% of the children in the cohort were selected as at risk for these limitations. Conclusion:With a prediction rule based on nine risk factors, postmeningitic children at high risk of developing academic and/or behavioural limitations could be identified. Additional research is required to further validate this prediction rule. In the future, a careful follow-up of high risk children may enhance early detection and treatment of these limitations.

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Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Prediction of academic and behavioural limitations in school‐age survivors of bacterial meningitis

Koomen

Grobbee²,

Roord

et al. 2004

Acta Paediatrica

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“…Em uma revisão de 4100 casos do Hospital Couto Maia, em Salvador, Bahia, a incidência foi de 45,8 casos por 100000 habitantes, com uma letalidade global de 33% 8 . Sequelas podem ocorrer, por vezes incapacitantes 3,12,20 . Na década atual, diversos países conseguiram reduzir muito a prevalência de meningites bacterianas na população, implantando o uso rotineiro da vacina conjugada para H. influenzae tipo b 1,11,21,23,25,26 .…”

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Etiologia de meningites bacterianas em uma amostra da população de Salvador - Bahia

Nascimento‐Carvalho

Moreno-Carvalho²

1998

Arq. Neuro-Psiquiatr.

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As meningites bacterianas constituem patologia importante na faixa etária pediátrica. Com o objetivo de conhecer a distribuição da etiologia desta patologia em uma amostra da população de Salvador, Bahia, foram analisados, retrospectivamente, 7000 exames de líquor, realizados entre setembro de 1988 e agosto de 1995, no laboratório de liquorologia da Fundação José Silveira. Foram selecionados 892 (12,7%) exames realizados em pacientes menores de 16 anos e com suspeita de meningite; entre os 139 casos de meningite bacteriana, H. influenzae tipo b foi o agente mais frequente (26,0%), ocorrendo em 100% das vezes em menores de 5 anos. Observou-se tendência na queda do número de casos de meningite por H. influenzae tipo b a partir de 1992. Questiona-se se este fato decorre do uso da vacina anti-H. influenzae tipo b nesta amostra da população.

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Global Case Fatality of Bacterial Meningitis During an 80-Year Period

van Ettekoven,

Liechti,

Brouwer

et al. 2024

JAMA Netw Open

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ImportanceThe impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain.ObjectiveTo describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis.Data SourcesGoogle Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality.Study SelectionIncluded studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care–associated meningitis, tuberculous meningitis, or missing outcome were excluded.Data Extraction and SynthesisData were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period’s year as an estimator variable were used.Main Outcome and MeasureCase fatality ratios of bacterial meningitis.ResultsThis review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients’ sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P &lt; .001).Conclusions and RelevanceIn this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

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Long Term Follow-Up of Estonian Children After Bacterial Meningitis

Cited by 13 publications

References 0 publications

Prediction of academic and behavioural limitations in school‐age survivors of bacterial meningitis

Prediction of academic and behavioural limitations in school‐age survivors of bacterial meningitis

Etiologia de meningites bacterianas em uma amostra da população de Salvador - Bahia

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

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