A Bi-centre Study of the Pattern and Evolution of readily detectable Neurological Sequelae of Acute Bacterial Meningitis

Abstract

The pattern and evolution of obvious post-meningitic sequelae were determined in 187 post-neonatal children followed up at two tertiary centres. The pattern of sequelae was classified using previously described schemes, as well as by the number of deficits per child. One hundred and eighty-seven children were assessed on discharge, 157 after six weeks of discharge and 134 after three months. The incidence of sequelae was 40/187 (21.4 percent) on discharge versus 23/157 (14.7 percent) after six weeks (p = 0.106) and 18/134 (13.4 percent) after three months (p = 0.069) of follow up. Two (1.4 percent) of the 147 children who were apparently normal on discharge had sequelae on follow up, while two (7.4 percent) of the 27 children discharged with major sequelae, died. Among 17 children who were followed up for at least six months, three (18 percent) at >6 wks to <6 months and ten (59 percent) at >6 months (p = 0.034) had persistent deficits. Among the 42 children with sequelae, 29 (69 percent) had major deficits alone (n = 15) or with minor deficits (n = 14). Fifteen (36 percent) had one, 14 (33 percent) two and 13 (31 percent) >3 deficits. There was full or partial resolution of deficits in 15/19 (79 percent) children with sequelae who were treated with and in 6/15 (40 percent) (p <0.05) who were not treated with dexamethasone on admission. There was no significant relationship between the pattern and evolution of sequelae and selected characteristics of the acute illness including its severity, pattern of aetiologic agents and response to initial antibiotic therapy. However, characteristics of the acute illness were significantly (p <0.01) associated with a high incidence of sequelae.


Nigerian Journal of Paediatrics 2003;30:27-35.