Image: PD/CDC. S.Pneumo
1. With respect to a comparison cohort, fewer patients with childhood history of meningococcal, pneumococcal, and H. influenzae meningitis completed high school or obtained higher education.
2. With respect to comparison cohort, fewer patients with childhood history of meningococcal, pneumococcal, and H. influenzae meningitis patients were economically self-sufficient in adulthood.
Evidence Rating Level: 2 (Good)
Study Rundown: This cohort study is one of the first studies to demonstrate that there may indeed be long-term effects of childhood meningitis that persist into adulthood. In examining the impact of environmental factors, the demonstrated lower educational level for patients with childhood meningococcus appears to be related to family related factors such as the level of parental education. On the other hand, environmental factors could not account for lower educational level of patients with childhood pneumococcal and H. influenzae meningitis. Therefore, patients with H influenza and pneumococcal meningitis may achieve lower educational levels due to the possible neurocognitive deficits produced by the meningitis itself. Among limitations, a more detailed analysis that accounted for the following factors: a) further stratification of meningococcal group according to socioeconomic status b) actual hospital courses of each patient diagnosed with childhood meningitis and c) increased virulence of different bacterial strains, would strengthen this study. Nonetheless, this large cohort study provides strong evidence that bacterial meningitis in childhood is associated with lower educational attainment and raises the need for possible psychosocial and educational support for patients following childhood bacterial meningitis.
Relevant Reading: Long-Term Mortality in Patients Diagnosed With Pneumococcal Meningitis
In-Depth [cohort study]: The authors used 4 cohorts identified from a Danish registry: 1) 2,924 patients with a history of meningococcal, pneumococcal, and H. influenza meningitis between 1977-2007 2) comparison cohort from general population matched by age and sex 3) full siblings of meningitis patients and 4) full siblings of comparison cohort. Cumulative incidence at age 35 of a) completion of high school b) completion of higher education and c) economic self-sufficiency and receipt of disability pension was measured. For meningococcal, pneumococcal and H.influenzae groups, significantly fewer patients completed high school and obtained higher education vs. comparison cohort (11% and 7.9%;10.2% and 8.9%; 5.5% and 6.5% respectively). For all three groups, fewer patients were economically self-sufficient and more patients received disability pension vs. comparison cohort (3.8% less and 1.5% more; 10.6% less and 8.7% more; 4.3% less and 3.7% more; respectively).
By Elizabeth Park and Rif Rahman
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