Academic achievements after childhood meningitis: a nationwide, population-based cohort study

Childhood meningitis may impact school performance.

To determine the association between bacterial or enteroviral meningitis in childhood and subsequent academic achievements.

We conducted a nationwide, registry-based cohort study in Denmark (1995-2021; follow-up until 2024), of children with bacterial (n = 672) or enteroviral meningitis (n = 611), stratified into young infants (0-<90 days) and older children (≥90 days-<17 years), an age- and sex-matched comparison cohort (n = 12,830), and siblings of all individuals (n = 16,810). We calculated mean final primary school exam grades, cumulative incidences of completion of primary school, high school and higher education, and differences between groups with 95% confidence intervals (CI).

Nearly all children completed primary school. Among children with bacterial meningitis, young infants had lower high-school completion compared to the comparison cohort (44% vs. 64%; difference: -20% (95% CI: -35%, -5%)). Among older children, high-school completion and completion of higher education were lower (54% vs. 61%; difference -7% (95% CI: -12%, -2%) and 33% vs. 39%; difference: -6% (95% CI: -12%, 0%)), but the same was observed for their siblings. Exam grades were lower for patients than the comparison cohort. Among children with enteroviral meningitis, academic achievements were not notably affected.

Bacterial meningitis in childhood was associated with lower academic achievements in young infants, whereas familial factors may explain the poorer outcomes among older children. Academic achievements were not notably affected after enteroviral meningitis. These findings suggest that follow-up and educational support is particularly important for young infants with bacterial meningitis.