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Children who are seen but not referred: hearing assessment after bacterial meningitis
A Riordan1, A Thomson, J Hodgson
1Institute of Child Health, Royal Liverpool Children's NHS Trust (Alder Hey), UK.
Insights
Many children treated for bacterial meningitis do not receive hearing assessments, leading to undetected hearing loss. Routine referral and follow-up at discharge and outpatient visits are recommended to improve audiological assessment rates.
Area of Science:
- Pediatrics
- Infectious Diseases
- Audiology
Background:
- Bacterial meningitis is a significant cause of pediatric hearing loss.
- Previous research indicates a gap in formal hearing assessments for childhood bacterial meningitis survivors.
- This study aimed to verify these findings within a specific hospital cohort.
Purpose of the Study:
- To audit the rate of hearing assessments in children treated for bacterial meningitis.
- To identify reasons for the lack of formal audiological evaluation.
- To propose strategies for improving hearing assessment rates in this vulnerable population.
Main Methods:
- Retrospective audit of hospital case notes and community audiological records.
- Inclusion of children directly admitted with bacterial meningitis between 1984 and 1991.
- Analysis of referral and attendance rates for hearing assessments among survivors.
Main Results:
- Of 181 survivors, 135 (75%) received a hearing assessment.
- Fifteen children (11.1% of assessed survivors) showed sensorineural hearing loss.
- The primary barrier to assessment was non-referral (31/46 cases), followed by non-attendance (12/46).
Conclusions:
- A significant proportion of childhood bacterial meningitis survivors do not undergo formal hearing assessments.
- Implementing routine hearing testing referrals at discharge and outpatient appointments is crucial.
- Improved audiological surveillance can mitigate the risk of untreated hearing loss in pediatric meningitis survivors.
Abstract:
Bacterial meningitis is an important cause of hearing loss in children. Previous studies have shown that a proportion of survivors of childhood bacterial meningitis do not have a formal hearing assessment. To confirm this finding amongst children treated for bacterial meningitis in our hospital, a retrospective audit was performed. The hospital case notes and community audiological records were examined to see how many children were referred for hearing assessment after their illness, and how many actually attended. Between 1984 and 1991, 194 children were directly admitted to our hospital with bacterial meningitis. Thirteen children died, and hearing assessment was carried out on 135 of the 181 survivors (75%), 15 of whom had evidence of sensorineural hearing loss. The major reason for hearing not being assessed was non-referral (31 out of 46 cases), 12 children did not attend for assessment despite referral, and three moved shortly after discharge. Thirty of the children remaining in the area who had no assessment (69.7%) were however seen in hospital out-patients. Routine referral for hearing testing at discharge, with re-referral at out-patient attendance, could help increase the number of children assessed after bacterial meningitis.