Sequelae due to bacterial meningitis among African children: a systematic literature review

Table 6 Post-discharge (PD) outcomes for all causes of confirmed bacterial meningitis (CBM), by study

Reference	Country	No. cases discharged	PD CFR	Average follow-up time, months	Total no. assessed for sequelae	HL (%)	VL (%)	CD (%)	SLD (%)	BP (%)	MI (%)	SZ (%)	Any neuropsychological sequelae (%)	Bacterial pathogens studied
[50]	Tunisia	85		60	82								13%	Spn, Hib, Nm
[41]	Egypt	367	0%	3	367	2%	0%	0%			1%		3%	Spn, Hib, Nm
[35]	Nigeria	47	0%		47							15%	23%	Spn, Hib, Nm, Klebsiella and others
[16]	Egypt	78		(2 to 24)	78		10%				10%		24%	Tuberculosis
[17]	Egypt	289		12	289		8%				7%		32%	Tuberculosis
[49]	Ethiopia				53	34%							34%^a	Spn, Hib, Nm, others
[36]	The Gambia	58	16%	8	48								13%	Hib
[48]	Cameroon			14	67	13%	3%	4%	4%	2%	3%^b	7%	25%	Spn, Hib, Nm, others
[60]	Sudan	34	10%	(3 to 48)	27	22%			7%	7%	7%	11%	33%	Spn, Hib, Nm and others
[22]	The Gambia	160	18%	(11 to 90)	73	33%	11%	22%			27%^c	19%	47%	Spn, Hib

The outcomes of children treated for all causes of CBM are shown for studies with >25 subjects. The number of cases discharged was calculated based on the number of CBM cases included in the study minus the number of children reported who died in-hospital. Post-discharge case fatality ratio (CFR) was calculated as the number of deaths after discharge divided by the number of cases with known follow-up; the denominator does not include cases lost to follow-up. Sequelae prevalence in children followed-up ranged from 3% to 47%. Half of the studies also had information on post-discharge CFR, which ranged from 0% to 18% in the period 3 to 90 months after illness.
^aEstimated 'Any neuropsychological sequelae' based on single sequelae type with largest proportion; ^bparalysis; ^cgross motor impairment.
BP = behavioural problem; CD = cognitive delay; Hib = Haemophilus influenzae type b; HL = hearing loss; MI = motor impairment; Nm = Neisseria meningitidis; Spn = Streptococcus pneumoniae; SLD = speech or language disorder; SZ = seizures; VL = vision loss.

ISSN: 1741-7015