Follow-Up of Cases of Haemophilus influenzae Type b Meningitis to Determine Its Long-Term Sequelae

• Published in: The Journal of pediatrics Vol. 163; no. 1; pp. S44 - S49
• Main Authors: Ahmed, A.S.M. Nawshad Uddin, FCPS, Khan, Naila Z., FCPS, PhD, Hussain, Manzoor, FRCP, FRCPCH, Amin, M. Ruhul, FCPS, Hanif, Mohammed, FCPS, FRCP, Mahbub, Mustafa, FCPS, El-Arifeen, Shams, MBBS, DrPH, Baqui, Abdullah H., MBBS, DrPH, Qazi, Shamim A., MD, Saha, Samir K., PhD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.07.2013
• Subjects: Adolescent; Bangladesh - epidemiology; Child; Child, Preschool; children with disabilities; complications (disease); death; developing countries; Disability Evaluation; Female; Follow-Up Studies; Haemophilus influenzae; hearing; Humans; immunization; Immunization Programs; Male; meningitis; Meningitis, Haemophilus - diagnosis; Meningitis, Haemophilus - epidemiology; Pediatrics; Prognosis; risk; vision; Bangladesh; BSID-II; Hib; Left against medical advice; Case fatality rate; Dhaka Shishu Hospital; CSF; Bailey Scales of Infant Development, Second Edition; DSH; LAMA; Cerebrospinal fluid; Haemophilus influenzae type b; CFR
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2013.03.030

Objective To measure physical and neurologic impact of Haemophilus influenzae type b (Hib) meningitis on surviving children through short- and long-term follow-up. Study design Cases of Hib meningitis, diagnosed at a tertiary level pediatric hospital, were subjected to short- and long-term follow-up and compared with age, sex, and area of residence matched healthy controls. Follow-up assessments included thorough physical and neurodevelopmental assessments using a standardized protocol by a multidisciplinary team. Results Assessments of short-term follow-up cohort (n = 64) revealed hearing, vision, mental, and psychomotor deficits in 7.8%, 3%, 20%, and 25% of the cases, respectively. Deficits were 10%, 1.4%, 21%, and 25% in long-term follow-up cohort (n = 71), in that order. Mental and psychomotor deficits were found in 2% of the controls, none of whom had vision or hearing deficits. Conclusions In addition to risk of death, Hib meningitis in children causes severe disabilities in survivors. These data facilitated a comprehensive understanding of the burden of Hib meningitis, specifically in developing countries where disabled children remain incapacitated because of lack of resources and facilities. The evidence generated from this study is expected to provide a compelling argument in favor of introduction and continuation of Hib conjugate vaccine in the national immunization program for children.