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

Abstract

The pattern, and evolution of obvious post-meningitic sequclae were determined in 187 post-neonatal children followed up at two tertiary centres. The pattern of sequelac was classified using previously described schemes, as well as by the sumber of deficits per child. One hundred and eighty-seven children were assessed on discharge, 157 after six wecks 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 wecks (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 apparendy normal on discharge had sequelac on follow up, while two (7.4 percent) of the 27 children discharged with major sequclae, died. Among 17 children who were followed up for at least six months, thrce (18 percent) at 26 wks to <6 months and ten (59 perrent) at 6 months (p = 0.034) had persistent deficits. Among the 42 children with sequelac, 29 (69 percent) had major deficits alone (n = 15) or with minor deficits (n = 14). Fifteen (36 percent) had onc, 14 (33 percent) two and 13 (31 percent) 23 deficits. There was full or partial resolution of deficits in 15/19 (79 percent) children with sequclae 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 sequclae and selected characteristics of the acute illness including its severity, pattern of actiologic agents and response to initial antibiotic therapy. However, characteristics of the scute illness were significantly <0.01) associated with high incidence of sequelac.