Children who get meningitis in their first year of life have a 10-fold increased risk of severe or moderate disability at 5 years of age compared with other children, concludes a study in this week's BMJ. These findings provide a complete picture of the range of problems experienced by children from England and Wales who have had meningitis in infancy.
Over 1,700 children who survived an acute attack of meningitis between 1985 and 1987 were identified. Children of the same age and sex, but who hadn't had meningitis, served as a control group. General practitioners and parents of children in both groups completed a questionnaire about the children's health and development. Children were allocated to one of four categories of disability, based on evidence of developmental problems.
Two per cent of children who survived the acute attack died before the age of 5 years. Among the survivors there was a 10-fold increase in the risk of severe or moderate disability compared with the control group. They also had an increased risk of mild disorders such as middle ear disease, squint, and behavioural problems. The researchers also found that children who had meningitis as newborns had more health and development problems than those infected after one month of age. The rates of disability also varied widely in children infected with different strains of bacteria.
In an accompanying editorial, Professor Keith Grimwood believes that doctors need not only to check vision and hearing after bacterial meningitis but also to ensure that caregivers and schoolteachers are aware of possible language deficits and problems understanding language based material. "Simple educational interventions may help compensate for these deficits, improving academic performance, behaviour and self esteem," he concludes.