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Psychiatric Disabilities and Other Long-term Consequences of Childhood Bacterial Meningitis
Urban Johansson Kostenniemi1,2, Aleksander Bazan1, Linda Karlsson2
1From the Department of Clinical Sciences, Pediatrics.
Insights
Childhood bacterial meningitis frequently leads to long-term psychiatric disabilities, affecting over a third of survivors. These conditions are often diagnosed late, necessitating updated screening guidelines for better detection and management.
Area of Science:
- Neurology
- Psychiatry
- Pediatrics
Background:
- Bacterial meningitis is a known cause of hearing and neurologic deficits in children.
- Long-term psychiatric disabilities following childhood bacterial meningitis are less understood.
Purpose of the Study:
- To assess the prevalence of psychiatric disabilities and other long-term consequences in childhood bacterial meningitis survivors.
- To identify potential risk factors associated with these disabilities.
Main Methods:
- A cohort of children with bacterial meningitis was selected from a validated dataset.
- Medical and child health records were reviewed to identify post-discharge disabilities.
- Statistical analyses, including confidence intervals and chi-squared tests, were employed.
Main Results:
- Permanent disabilities were observed in 56% of 80 survivors over a mean follow-up of 19 years.
- Psychiatric disease affected 30% of survivors, with an additional 5% under investigation.
- Hearing impairments (≥30%) and neurologic deficits (≥23%) were also common.
Conclusions:
- Psychiatric disabilities are a common and significant long-term outcome of childhood bacterial meningitis, affecting over one-third of survivors.
- The late detection of psychiatric issues highlights the need for revised guidelines focusing on long-term monitoring.
- Current predictive models are insufficient, emphasizing the need for proactive screening strategies.
Background:
Bacterial meningitis is known to cause hearing impairments and neurologic deficits; however, less is known regarding psychiatric disabilities. In this study, we assessed psychiatric disabilities and other long-term consequences of childhood bacterial meningitis.
Methods:
From a previously validated dataset, we selected children having had bacterial meningitis. We then reviewed medical records and child health records from discharge onwards to identify disabilities. We calculated the occurrence of disabilities with a 95% confidence interval (CI), and we used a χ test to assess possible individual risk factors associated with occurrence of disabilities.
Results:
Of the 80 children included in this study, permanent disabilities not attributed to preexisting diseases were noted in 56% (CI: 45-67) during the mean observation period of 19 years and 2 months. Psychiatric disease was diagnosed in 30% (CI: 21-41), and another 5% (CI: 2-13) were under ongoing investigations for symptoms of psychiatric disease. Hearing impairments affected at least 30% (CI: 20-40), and neurologic deficits affected at least 23% (CI: 15-34). While other disabilities were often detected within the first year, psychiatric disabilities were detected after a mean time period of 14 years (CI: 11:1-16:11). Although some associations were noted, no individual risk factor was able to predict the occurrence of disabilities.
Conclusions:
Psychiatric disabilities affect more than one-third of survivors and are among the most common long-term consequence of childhood bacterial meningitis. Late discovery and predictive difficulties call for a revision of current guidelines to include a specific long-term strategy for detecting psychiatric disabilities.
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