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The impact of Haemophilus influenzae type b meningitis on nutritional status
B Sherry1, A Weber, J Williams-Warren
1Division of Infectious Disease, Children's Hospital and Medical Center, Seattle, WA 98105.
Insights
Haemophilus influenzae type b meningitis caused temporary nutritional issues in children. However, long-term follow-up revealed increased weight-for-height percentiles, with many children becoming obese post-infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Haemophilus influenzae type b (Hib) meningitis is a serious infection with potential long-term health consequences.
- The impact of Hib meningitis on children's nutritional status and growth requires further investigation.
Purpose of the Study:
- To assess the immediate and long-term effects of Hib meningitis on nutritional status and growth in pediatric patients.
- To evaluate changes in weight-for-height percentiles and specific nutritional markers following Hib meningitis.
Main Methods:
- Prospective study of 111 children hospitalized with Hib meningitis.
- Monitoring weight changes during hospitalization and tracking weight-for-height percentiles at 1, 3, and 6 months post-admission.
- Assessing nutritional status markers including serum prealbumin, erythrocyte glutathione reductase activity, and free erythrocyte protoporphyrin-heme ratio at different time points.
Main Results:
- Children experienced a minimal weight loss during hospitalization (<1%).
- Weight-for-height percentiles significantly increased post-admission, with 43% of children exceeding the 75th percentile at 6 months.
- Long-term follow-up (1.17-5.5 years) indicated that 43% of a subset remained obese.
- Significant improvements were observed in serum prealbumin levels and erythrocyte glutathione reductase activity coefficients during hospitalization.
- The free erythrocyte protoporphyrin-heme ratio increased between days 5 and 10 of hospitalization.
Conclusions:
- Hib meningitis leads to transient adverse nutritional changes.
- Children who experience Hib meningitis are at an increased risk of developing obesity in the long term.
Abstract:
We investigated the immediate impact and long-term effects of Haemophilus influenzae type b meningitis on nutritional status and growth in 111 children. Mean weight change during 10 d of hospitalization was a loss of less than 1%. Follow-up median weight-for-height percentiles increased after admission (p less than 0.01). Percentile values were as follows: admission, 45th; 1 mo, 60th; 3 mo, 60th; and 6 mo, 68th. Forty-three percent of the cases were greater than 75th percentile of weight-for-height at 6 mo after disease. An additional follow-up assessment of weight-for-height indicated that 43% of a representative sample subset of 49 were still obese 1.17-5.5 y after disease. Significant differences in median concentrations of serum prealbumin were found between days 1 (128 mg/L) and 5 (199 mg/L, p less than 0.0001) and days 5 and 10 (214 mg/L, p less than 0.02). Median erythrocyte glutathione reductase activity coefficients increased between days 1 (1.16) and 5 (1.20, p less than 0.01). The mean free erythrocyte protoporphyrin-heme ratio increased between days 5 (10.78 X 10(-6)) and 10 (14.22 X 10(-6), p less than 0.01). We conclude that there were transient adverse changes in nutritional status. Obesity appears to occur after disease.