Bedford, Helen Elizabeth; (2000) Meningitis in infancy: A five year follow-up. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The aim of the thesis is to describe the consequences of meningitis experienced by children in the first year of life. One thousand five hundred and eighty four children who suffered meningitis infancy and were identified through an active reporting system, were followed up at five years of age, together with a comparison group matched for age, sex and general practitioner. Information on their health and development was by collected by postal questionnaire from GPs and parents for both groups of children. A particular focus of this study was the consequences of bacterial meningitis in the first year of life. At five years of age, the majority of children in the meningitis group were reported to have no health and development problems, or to have only minor conditions that are prevalent in the childhood population. However, in all domains the children in the meningitis group were at increased risk of problems. This was particularly true with respect to motor deficits (RR 8.6) and learning problems (RR 7.0); the relative risk of sensori-neural hearing loss for children who had meningitis in infancy was 22.8. On the basis of the information received from both sources, children were assessed according to the severity of their disability. Overall, 5.8% of children in the meningitis group had severe multiple disabilities at five years of age. For children who had suffered bacterial meningitis, the rate was 4%. Factors found to be associated with a poor outcome at five years included prematurity, low birthweight, age at meningitis, coma and convulsions on admission. After controlling for all other significant factors, coma on admission and acute complications remained independent risk factors for poor outcome at five years. The findings confirm the deleterious effects of meningitis in the first year of life, and highlight the importance of careful assessment of children who have experienced the infection.

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