Prognostic Value and Changes of Auditory Brain Stem Response in Children With Bacterial Meningitis in Luanda, Angola

Area of Science:

• Neuroscience
• Pediatrics
• Audiology

Background:

• Bacterial meningitis (BM) poses a significant threat to children globally, particularly in low-resource settings.
• Neurological sequelae are common complications of BM, necessitating reliable prognostic tools.
• Auditory brainstem response (ABR) assesses auditory pathway function, potentially offering insights into neurological status.

Purpose of the Study:

• To evaluate the utility of single and repeated auditory brainstem response (ABR) tests in predicting mortality and severe neurological injury in children with bacterial meningitis (BM).
• To compare ABR findings in children with BM to age-matched normative data.
• To investigate the correlation between ABR abnormalities and clinical outcomes in pediatric BM patients.

Main Methods:

• Analyzed ABR traces from 221 children (2 months–12 years) with BM upon admission, comparing them to normative data.
• Assessed the predictive value of ABR trace absence and delay for mortality and severe neurological injury.
• Utilized repeated ABR in 166 children to evaluate outcomes based on response presence/absence at 80 dB nHL.

Main Results:

• Absence of typical ABR waveforms individually did not predict poor outcomes.
• Children with BM exhibited significantly prolonged ABR latencies and interpeak latencies (IPLs) compared to controls.
• Prolongation of latencies and IPLs at the group level correlated with higher rates of mortality or severe neurological sequelae.

Conclusions:

• Bacterial meningitis demonstrably affects neural conduction time within the auditory pathway.
• Auditory brainstem response (ABR) appears insufficient for individual prognostication in pediatric BM within similar resource-limited settings.
• Group-level analysis of delayed ABR latencies and IPLs shows an association with poorer clinical outcomes.