Meningitis in infancy in England and Wales: follow up at age 5 years

Bedford, Helen; Louvois, J. de; Halket, S; Peckham, Catherine; Hurley, Rosalinde; Harvey, David

doi:10.1136/bmj.323.7312.533

Cited by 277 publications

(198 citation statements)

References 13 publications

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“…A ausência de alteração do nível de consciência e a presença de petéquias, por indicar possível etiologia por N. meningitidis, denotaram uma evolução mais favorável para os pacientes. Em comparação com a literatura, os sinais de alerta para morbidade decorrente de MBA são compatíveis 3,13,15,16,21,22 . Nota-se apenas uma divergência em relação aos achados laboratoriais, uma vez que, no presente estudo, neutropenia, e não leucopenia 16 , foi apontada como um sinal de alerta para a ocorrência de complicação neurológica aguda.…”

Section: Discussionunclassified

“…Alteração comportamental, atraso no desenvolvimento psicomotor, retardo mental, epilepsia e alteração de nervo craniano foram as sequelas mais frequentemente encontradas, fato também observado por outros autores 3,12,22 .…”

Section: Discussionunclassified

“…É importante destacar que diversos estudos relatam o déficit auditivo como umas das sequelas mais importantes e frequentes das MBAs na infância 3,12,19,22,23 , dado não confirmado neste estudo, uma vez que somente 11 avaliações audiológicas foram recuperadas, dentre os 35 pacientes que tiveram seguimento, dos quais dois apresentaram perda auditiva condutiva. Devemos ressaltar que todos os pacientes utilizaram corticosteróides endovenosos no primeiro dia do atendimento, rotina do serviço, devido à comprovação da eficácia do mesmo na prevenção da surdez em estudos controlados 24 .…”

Section: Discussionunclassified

“…Meningite bacteriana causada por S. pneumoniae foi selecionada como fator de risco para o desenvolvimento de complicações neurológicas agudas [razão de chances (odds ratio, OR) = 6,4; intervalo de confiança (IC) 1,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]7], assim como neutropenia < 60% (p < 0,01). …”

Section: Métodosunclassified

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Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae

Antoniuk¹,

Hamdar²,

Ducci³

et al. 2011

J Pediatr (Rio J)

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Objective: To assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs. Methods:This retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006. Results:Of the 44 patients studied, 17 (38.6%) had acute neurological complications. Seizure was the most frequent (31.8%) complication. Patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03), seizure at admission (p < 0.01), and S. pneumoniae as the etiologic agent (p = 0.01). Risk factors for the development of acute neurological complications were S. pneumoniae (odds ratio [OR] = 6.4, confidence interval [CI] 1.7-24.7) and neutrophil count < 60% (p < 0.01). Of the 35 patients who were followed up, 14 had neurological sequelae (40%). Behavioral change (22.9%) was the most frequent sequela. Seizures at admission (OR = 5.6, CI 1.2-25.9), cerebrospinal fluid protein concentration > 200 mg/dL (p < 0.01), and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae. Conclusion:Neutrophil count < 60%, seizure at admission, and S. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications, while protein levels, cerebrospinal fluid glucose concentration/glycemia ratio, and seizure at admission were seen as risk factors for neurological sequelae.J Pediatr (Rio J). 2011;87(6):535-40: Bacterial meningitis, neurological complications, neurological follow-up, pediatrics. ResumoObjetivo: Estudo retrospectivo que visa avaliar as complicações neurológicas agudas e sequelas neurológicas das meningites bacterianas agudas na infância, a fim de determinar possíveis sinais de alerta. Conclusão: Contagem de neutrófilos < 60%, crise convulsiva na admissão e S. pneumoniae como agente etiológico foram identificados como sinais de alerta para a ocorrência de complicação neurológica aguda, enquanto que proteinorraquia, menor relação glicorraquia/glicemia e crise convulsiva na internação foram observados como fatores de risco para a ocorrência de sequelas neurológicas.J Pediatr (Rio J). 2011;87(6):535-40

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Section: Discussionunclassified

Section: Métodosunclassified

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Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae

Antoniuk¹,

Hamdar²,

Ducci³

et al. 2011

J Pediatr (Rio J)

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“…Invasive Pneumococcal Disease (IPD) is associated with high mortality rates [3,4] and may cause severe lifelong complications [5,6]. Non-invasive pneumococcal disease causes a high burden to society due to the high incidence of infection-related disease, such as otitis media and pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

Hubben

Bos

Glynn³

et al. 2007

Vaccine

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Enhanced decision support for policy makers using a web interface to health-economic models -Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands Hubben, G.A.A.; Bos, J.M.; Glynn, D.M.; op 't Ende, Anna; van Alphen, L.; Postma, Maarten Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. AbstractWe have developed a web-based user-interface (web interface) to enhance the usefulness of health-economic evaluations to support decision making (http://pcv.healtheconomics.nl). It allows the user to interact with a health-economic model to evaluate predefined and customized scenarios and perform sensitivity analysis. To explore its usefulness, it was applied to an evaluation of cost-effectiveness of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine (PCV7), that was used to support a policy decision on the inclusion of PCV7 in the national vaccination program (NVP) of the Netherlands. We used a decision-tree analytic model to project the impact of infant vaccination with four doses of PCV7 on an annual cohort of infants born in the Netherlands. The base-case analysis includes the beneficial effects on unvaccinated individuals (herd protection). Additional scenarios varying the number of doses, discount rate for effects and the number of serotypes in the vaccine were evaluated and can be analysed on the web. Our model projects a base-case incremental cost-effectiveness ratio (iCER) of D 14,000 (95% uncertainty interval (UI): 9,800-20,200) per quality adjusted life year (QALY) or D 15,600 (95% UI: 11,100-23,900) per life year gained (LYG).

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Educational Achievement and Economic Self-sufficiency in Adults After Childhood Bacterial Meningitis

Roed¹,

Omland²,

Skinhøj³

et al. 2013

JAMA

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Importance To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood. Objective To study educational achievement and economic self-sufficiency in adults diagnosed as having bacterial meningitis in childhood. Design, Setting, and Participants Nationwide population-based cohort study using national registries of Danish-born children diagnosed as having meningococcal, pneumococcal, or Haemophilus influenzae meningitis in the period 1977-2007 (n=2784 patients). Comparison cohorts from the same population individually matched on age and sex were identified, as were siblings of all study participants. End of study period was 2010. Main Outcomes and Measures Cumulative incidences of completed vocational education, high school education, higher education, time to first full year of economic self-sufficiency, and receipt of disability pension and differences in these outcomes at age 35 years among meningitis patients, comparison cohorts, and siblings. Results By age 35 years, among persons who had a history of childhood meningococcal (n=1338), pneumococcal (n=455), and H influenzae (n=991) meningitis, an estimated 11.0% (41.5% vs 52.5%; 95% CI, 7.3%-14.7%), 10.2% (42.6% vs 52.8%; 95% CI, 3.8%-16.6%), and 5.5% (47.7% vs 53.2%; 95% CI, 1.9%-9.1%) fewer persons, respectively, had completed high school and 7.9% (29.3% vs 37.2%; 95% CI, 1.6%-14.2%), 8.9% (28.1% vs 37.0%; 95% CI, 0.6%-17.2%), and 6.5% (33.5% vs 40.0%; 95% CI, 1.4%-11.6%) fewer had attained a higher education compared with individuals from the comparison cohort. Siblings of meningococcal meningitis patients also had lower educational achievements, while educational achievements of siblings of pneumococcal and H influenzae meningitis patients did not differ substantially from those in the general population. At end of follow-up, 3.8% (90.3% vs 94.1%; 95% CI, 1.1%-6.5%), 10.6% (84.0% vs 94.6%; 95% CI, 5.1%-16.1%), and 4.3% (90.6% vs 94.9%; 95% CI, 2.0%-6.6%) fewer meningococcal, pneumococcal, and H influenzae meningitis patients were economically self-sufficient and 1.5% (3.7% vs 2.3%; 95% CI, Ϫ0.2% to 3.2%), 8.7% (10.0% vs 1.3%; 95% CI, 5.0%-12.4%), and 3.7% (6.2% vs 2.5%; 95% CI, 1.6%-5.8%) more received disability pension compared with individuals from the comparison cohort. Conclusions and Relevance In a Danish population, bacterial meningitis in childhood was associated with lower educational achievement and economic selfsufficiency in adult life. This association may apply particularly to pneumococcal and H influenzae meningitis, whereas for meningococcal meningitis the lower educational achievement may be family-related.

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Meningitis in infancy in England and Wales: follow up at age 5 years

Cited by 277 publications

References 13 publications

Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae

Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

Educational Achievement and Economic Self-sufficiency in Adults After Childhood Bacterial Meningitis

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