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

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7312.533 (Published 08 September 2001) Cite this as: BMJ 2001;323:533
  1. Helen Bedford, senior research fellow (h.bedford{at}ich.ucl.ac.uk)a,
  2. John de Louvois, directorb,
  3. Susan Halket, senior scientistc,
  4. Catherine Peckham, professor of paediatric epidemiologya,
  5. Rosalinde Hurley, professor of microbiologyc,
  6. David Harvey, professor of paediatrics and neonatal medicinec
  1. a Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EH
  2. b Public Health Laboratory Service, Environmental Surveillance Unit, London NW9 5EQ
  3. c The Karim Centre for Meningitis Research, Imperial College School of Medicine, Department of Paediatrics and Neonatal Medicine, Queen Charlotte's and Chelsea Hospital, London W6 OXG
  1. Correspondence to: H Bedford
  • Accepted 8 March 2001

Abstract

Objective: To describe important sequelae occurring among a cohort of children aged 5 years who had had meningitis during the first year of life and who had been identified by a prospective national study of meningitis in infancy in England and Wales between 1985 and 1987.

Design: Follow up questionnaires asking about the children's health and development were sent to general practitioners and parents of the children and to parents of matched controls. The organism that caused the infection and age at infection were also recorded.

Setting: England and Wales.

Participants: General practitioners and parents of children who had had meningitis before the age of 1 year and of matched controls.

Main outcome measures: The prevalence of health and developmental problems and overall disability among children who had had meningitis compared with controls.

Results: Altogether, 1584 of 1717 (92.2%) children who had had meningitis and 1391 of 1485 (93.6%) controls were successfully followed up. Among children who survived to age 5 years 247 of 1584 (15.6%) had a disability; there was a 10-fold increase in the risk of severe or moderate disability at 5 years of age among children who had had meningitis (relative risk 10.3, 95% confidence interval 6.7 to 16.0, P<0.001). There was considerable variation in the rates of severe or moderate disability in children infected with different organisms.

Conclusion: The long term consequences of having meningitis during the first year of life are significant: 32 of 1717 (1.8%) children died within five years. Not only did almost a fifth of children with meningitis have a permanent, severe or moderately severe disability, but subtle deficits were also more prevalent.

What is already known on this topic

What is already known on this topic Meningitis in infancy is associated with important long term consequences

There is considerable variation in outcome depending on which organism caused the infection

What this study adds

What this study adds This follow up study of 1717 children who had meningitis in infancy found that they had a 10-fold increase in risk of severe or moderate disabilities at age 5 years compared with children in the control group

The outcome of having meningitis was associated with the age at infection, and children who had meningitis in the neonatal period were more likely to have health and development problems than those older than 1 month Subtle deficits, such as middle ear disease and visual and behavioural problems, were more prevalent among children who had had meningitis in infancy

Footnotes

  • Funding Action Research and the Fayed Charitable Foundation.

  • Competing interests None declared.

  • Accepted 8 March 2001
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