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OBJECTIVE: This study investigated executive functions (EFs) in young adult survivors of childhood bacterial meningitis (BM). These skills are important for normal development, and their potential vulnerability in early years suggests that childhood BM could affect executive functions in the longer term. METHOD: The adult self-report Behavior Rating Inventory of Executive Function was administered to 474 young adult survivors of childhood BM who participated in the 20|30 Dutch Postmeningitis study. Average scores were compared to population-norm group scores. Subgroup scores were compared according to causative pathogen and age at onset. RESULTS: Young adult survivors of childhood BM scored lower on overall metacognition than the age-matched population norm group. Young adult survivors of childhood BM caused by Streptococcus pneumoniae, S. agalactiae, or Escherichia coli had lower scores than cases caused by Neisseria meningitidis. Survivors with age-at-onset below 12 months had a higher (worse) overall EF score than survivors with age-at-onset above 12 months. CONCLUSIONS: Young adult survivors of childhood BM experience difficulties in EF. However, most of the self-reported EF scores were within the norm. Future studies need to additionally assess EF in adult survivors of childhood BM using performance-based tests.
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Background: This retrospective hospital-based surveillance aimed to assess the epidemiology, causative pathogens trend, and serotypes distribution of pneumococcal meningitis among children aged under 5 years with bacterial meningitis in Southern Vietnam after the introduction of pentavalent vaccine in the Expanded Program on Immunization (EPI). Methods: From 2012 to 2021, cerebrospinal fluid samples were collected from children aged under 5 years with suspected bacterial meningitis at Children's Hospitals 1 and 2 in Ho Chi Minh City. Probable bacterial meningitis (PBM) cases were identified using biochemistry and cytology. Real-time polymerase chain reaction was used to confirm cases of confirmed bacterial meningitis (CBM) caused by Streptococcus pneumoniae, Haemophilus influenzae, or Neisseria meningitidis. Streptococcus pneumoniae serotyping was performed. Results: Of the 2560 PBM cases, 158 (6.2%) were laboratory-confirmed. The CBM proportion decreased during the 10-year study and was associated with age, seasonality, and permanent residence. Streptococcus pneumoniae was the most common pathogen causing bacterial meningitis (86.1%), followed by H influenzae (7.6%) and N meningitidis (6.3%). The case-fatality rate was 8.2% (95% confidence interval, 4.2%-12.2%). Pneumococcal serotypes 6A/B, 19F, 14, and 23F were the most prevalent, and the proportion of pneumococcal meningitis cases caused by the 10-valent pneumococcal conjugate vaccine (PCV) serotypes decreased from 96.2% to 57.1% during the PCV eras. Conclusions: Streptococcus pneumoniae is the most frequent causative agent of bacterial meningitis in children aged under 5 years in Southern Vietnam over the last decade. Policymakers may need to consider introducing PCVs into the EPI to effectively prevent and control bacterial meningitis.
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OBJECTIVE: To assess the role of single and repeated auditory brain stem response (ABR) in predicting mortality and severe neurological injury among children having bacterial meningitis (BM) in Luanda, Angola. METHODS: The morphology of ABR traces of 221 children (aged 2 months to 12 years) from admission day was analyzed and compared with age-matched normative data. Absence and delay of traces were compared with mortality and mortality or severe neurological injury in subgroup analyses. Outcome was also evaluated with repeated ABR of 166 children based on presence or absence of responses at 80 dB nHL (normal hearing level) stimulation level. RESULTS: Individually, the absence of typical ABR waveform did not signify poor outcome. At the group level, latencies and interpeak latencies (IPLs) were significantly prolonged among patients with BM in comparison with controls, and the prolongation correlated with higher mortality or severe neurological sequelae. CONCLUSIONS: We confirmed the effect of BM on neural conduction time in auditory pathway. However, ABR in similar settings seems not useful for individual prognostication, although at the group level, delayed latencies, IPLs, or both associated with poorer outcome.
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AIM: In 2004, a model identifying children at risk of academic or behavioural limitations after bacterial meningitis (BM) was presented. Risk factors were male gender, low birthweight, lower educational level of the father, Streptococcus pneumoniae, lower cerebrospinal fluid (CSF) leucocyte count, delay between admission and start of antibiotics, dexamethasone <2 days, seizures and prolonged fever. The aim of this study was to validate that prediction model in an independent cohort. METHODS: Academic or behavioural limitations were determined in 93 Dutch school-age BM survivors. Risk factors for limitations were obtained from medical files. Validation was performed by applying the model in the cohort, then assessing discrimination and goodness of fit. Multiple imputation techniques were used to deal with missing values. RESULTS: Although fit of the model appeared good when it came to similarity of expected and observed cases (p-value of the Hosmer-Lemeshow test 0.24-0.57), discrimination was poor. Area under the curve (AUC) of the receiver operated characteristics (ROC) curve of the model was 0.83 (95% CI: 0.77-0.89) in the development cohort and 0.53 (95% CI: 0.41-0.65) in the validation cohort. CONCLUSION: External validation of the model was unsuccessful. It is not suitable for implementation in practice.
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Child Behavior , Learning Disabilities/etiology , Meningitis, Bacterial/complications , Models, Theoretical , Case-Control Studies , Child , Cohort Studies , Female , Humans , Male , Meningitis, Bacterial/psychology , NetherlandsABSTRACT
Background. Bacterial meningitis is a severe, potentially life-threatening infection that is associated with high rates of morbidity and significant disability in survivors. Overall mortality rates related to bacterial meningitis of around 20% to 25% have been reported by major centers. Our study is to determine the incidence rate and etiology of childhood bacterial meningitis in Ulaanbaatar, Mongolia.Methods. From 2002-2010, a total of CSF 433 and blood 544 samples were obtained from children age 0-5 years old. The following diagnostic criteria for bacterial meningitis in children aged 0-5 years were used: questionnaires, clinical signs and positive CSF culture and/or CSF antigen test results positive N. meningitis serogroups B, A, C, Y, and W-135, Hib or S.pneumonia; and/or positive CSF PCR results; and/or positive blood culture results with CSF pleocytosis (WBC count, >10 cells/uL). Pathogens were identified and serotype or serogroup with standard methods in the reference microbiology laboratory. Detection of bacterial pathogens with a multiplex and real-time PCR assay.Results. From totally 544 suspected cases had been detected bacterial meningitis in 260 (47, 8%) cases and sepsis in 111 [20,4%] cases respectively. The disease in the 83 [27.1 %] etiologically diagnosed patients was due to H.influenza, S. pneumonia was in 71 [36, 4%] cases and N.meningitis in 111 [24, 7%] respectively. Among the positive samples 80.6% (129/160) the specific serogroup and/or serotypes for N.meningitis serogroups A was available in 22(35, 4%) cases, for the Hib 52(96, 3%) and 6(40%) for the S.pneumoniae 7 serotype. The real time PCR assay was more sensitive for detection of meningitis pathogens than conventional methods (culture and latex agglutination), 19% in comparison with latex agglutination (p<0.0026) and by 39% in comparison with culture (p<0.001). Bacterial meningitis was identified 70.0 in 2004 among population, but it reduced until 5.0 in 2009. The incidence of Hib meningitis was 2002-2005y, N.meningitis and S.pneumoniae meningitis were 2006-2008y, S.pneumonia meningitis was more higher 2009-201 Oy comparing with other pathogens.Conclusion. N.meningitidls, S.pneumoniae H.influenzae type b are the leading causative agents of childhood bacterial meningitis in Ulaanbaatar, and the incidence rate is higher than what were reported in other Asian countries.
