Significant sequelae after bacterial meningitis in Niger: a cohort study

BMC Infectious Diseases

Jean-Marc Collard³  Abdoul Aziz Yazi¹  Zilahatou Tohon⁴  Jean-François Jusot² 

[1] Epidemiology Unit, Epicentre, PO Box 13330, Niamey, Niger;Epidemiology/Health-Environment-Climate Unit, Centre de Recherche Médicale et Sanitaire, PO Box 10887, Niamey, Niger;Biology Unit, Centre de Recherche Médicale et Sanitaire, PO Box 10887, Niamey, Niger;Epidemiolgy DrPH Candidate, College of Public Health, University of Kentucky, 111 Washington Avenue, Lexington, KY 40536-0003, USA

关键词: Less-developed countries;    Disability;    Complications;    Meningococcal;   

Others  :  1148306
DOI  :  10.1186/1471-2334-13-228

 received in 2012-07-17, accepted in 2013-05-15,  发布年份 2013

【 摘 要 】

Background

Beside high mortality, acute bacterial meningitis may lead to a high frequency of neuropsychological sequelae. The Sahelian countries belonging to the meningitis belt experience approximately 50% of the meningitis cases occurring in the world. Studies in Africa have shown that N. meningitidis could cause hearing loss in up to 30% of the cases, exceeding sometimes measles. The situation is similar in Niger which experiences yearly meningitis epidemics and where rehabilitation wards are rare and hearing aids remain unaffordable. The aim of this study was to estimate the frequency of neuropsychological sequelae after acute bacterial meningitis in four of the eight regions of Niger.

Methods

Subjects exposed to acute bacterial meningitis were enrolled into a cohort with non exposed subjects matched on age and gender. Consenting subjects were interviewed during inclusion and at a control visit two months later. If clinical symptoms or psychological troubles persisted at both visits among the exposed subjects with a frequency significantly greater than that observed among the non exposed subjects, a sequelae was retained. The comparison of the frequency of sequelae between non exposed and exposed subjects to bacterial meningitis was also calculated using the Fisher exact test.

Results

Three persisting functional symptoms were registered: headaches, asthenia, and vertigo among 31.3, 36.9, and 22.4% respectively of the exposed subjects. A significant motor impairment was retrieved among 12.3% of the exposed versus 1.6% of the non exposed subjects. Hearing loss significantly disabled 31.3% of the exposed subjects and 10.4% exhibited a serious deafness.

Conclusions

This study carried out in Niger confirms two serious neurological sequelae occurring at high frequencies after bacterial meningitis: severe and profound hearing loss and motor impairment. Cochlear implantation and hearing aids are too expensive for populations living in developing countries. Neurological sequelae occurring after meningitis should sensitize African public health authorities on the development of rehabilitation centers. All these challenges can be met through existing strategies and guidelines.

【 授权许可】

   
2013 Jusot et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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