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Hearing impairment in Angolan children with acute bacterial meningitis with and without otitis media
Laura Lempinen1, Anu Laulajainen-Hongisto1, Antti A Aarnisalo1
1Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Childhood bacterial meningitis (BM) can cause hearing loss. This study found hearing impairment is common in BM, with or without otitis media (OM), and linked to worse outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Audiology
Background:
- Bacterial meningitis (BM) is a significant cause of acquired hearing loss in children.
- Otitis media (OM) is a common childhood infection that can also affect hearing.
- The interplay between BM, OM, and hearing outcomes in pediatric populations requires further investigation, particularly in under-resourced regions.
Purpose of the Study:
- To investigate the bacterial causes of BM.
- To assess hearing impairment in children with BM.
- To compare hearing outcomes in children with BM, with and without concomitant OM, in Angola.
Main Methods:
- Auditory brainstem response testing was used to assess hearing in 391 children with confirmed BM.
- Bacteriology of ear discharge and cerebrospinal fluid (CSF) were compared.
- Hearing was evaluated on hospital days 1 and 7, and at 1, 3, and 6-month follow-ups, comparing groups with and without OM.
Main Results:
- No correlation was found between bacteria in ear discharge and CSF.
- Hearing impairment (>40 dB) was prevalent on day 7 in hospital, affecting 27% of children without OM and 30% with OM.
- Any hearing deficit during hospitalization was associated with an increased risk of complicated or fatal clinical course (OR 2.76).
Conclusions:
- Hearing thresholds did not significantly differ between children with or without OM during hospitalization or follow-up.
- Hearing impairment in children hospitalized with BM is a significant risk factor for a complicated clinical course or death.
- Early identification and management of hearing deficits in pediatric BM are crucial for improving patient outcomes.
Aim:
Bacterial meningitis (BM) is a common cause of hearing loss in childhood. Our aim was to investigate bacterial aetiology, hearing impairment and outcome in childhood BM with vs. without otitis media (OM) in Angola.
Methods:
Hearing was tested by auditory brainstem response in 391 (76%) children with confirmed BM. The bacteria identified from the ear discharge were compared to those from cerebrospinal fluid (CSF). The hearing findings were compared among children with vs. without OM on days 1 and 7 of hospitalization, and at follow-ups of 1, 3 and 6 month(s).
Results:
No correlation was found in bacteriology between the ear discharge and CSF. On day 7 in hospital, hearing impairment (>40 dB) was common, regardless of whether concomitant OM or not (in 27% vs. 30%, respectively). Any hearing deficit on day 7 was associated with a higher risk of complicated or fatal clinical course (OR 2.76, CI95% 1.43-5.29, p = 0.002).
Conclusion:
No significant difference prevailed in hearing thresholds between children with or without OM in hospital on day 7 or at later follow-ups. Any hearing impairment during hospital stay associated with a higher risk for complicated clinical course or death.
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