Long term sequelae of childhood acute bacterial meningitis in a developing country: A study from the sudan

Abstract

35 survivors of acute bacterial meningitis (ABM) from a group of 44 Sudanese children—seen during 18 months (April 1985–November 1986)–were prospectively followed to ascertain the long-term sequelae of the disease. 30 (17 with Haemophilus influenza, 8 Neisseria meningitidis, 4 Streptococcus pneumoniae and one child with Enterobacter cloacae meningitis) could be followed during the surveillance period (3–4 years). Three (10%), including 2 with hemiplegia, died after 11–12 months. The association between motor deficit on discharge from hospital and subsequent death was significant (p=0.04). Of the remaining 27, neuropsychologic sequelae were recorded in 9 (33%). Sensorineural hearing loss was observed in 6 (22%) patients and improved in one during surveillance. Motor deficits were found to improve with time but were replaced by the development of epilepsy about 3 years later in 11% of the survivors. The mean IQ (±SD) score for a subgroup of 19 post-meningitic children (92.3±13.9) was found to be significantly lower than in their nearest-age sibling controls (100.7±10.2; p = <0.01). Younger age at admission and longer duration of ABM symptoms before treatment were significantly associated with poorer outcome (respectively, r=0.63, p= <0.01, r=0.67, p= <0.01). The potential impact of vaccination against the commonest organisms causing ABM in developing countries is discussed.