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. 2024 Dec 2;7(12):e2445497.
doi: 10.1001/jamanetworkopen.2024.45497.

Adult Work Ability Following Diagnosis of Bacterial Meningitis in Childhood

Salini Mohanty  1 , Urban Johansson Kostenniemi  2 , Sven Arne Silfverdal  3 , Stina Salomonsson  4 , Federico Iovino  5 , Goran Bencina  6 , Eleana Tsoumani  7 , Gustaf Bruze  8
Affiliations

Adult Work Ability Following Diagnosis of Bacterial Meningitis in Childhood

Salini Mohanty et al. JAMA Netw Open. .

Abstract

Importance: A diagnosis of bacterial meningitis in childhood can lead to permanent neurological disabilities. Few studies have examined long-term consequences for work ability in adulthood.

Objective: To compare earnings, work loss, and educational attainment between adults diagnosed with bacterial meningitis in childhood and population comparators.

Design, setting, and participants: This nationwide registry-based matched cohort study included individuals in Sweden diagnosed with bacterial meningitis in childhood (aged <18 years) from January 1, 1987, to December 31, 2019, and general population comparators matched 1:9 on age, sex, and place of residence. Follow-up was completed December 31, 2020. Data were analyzed from February 7 to September 12, 2023.

Exposure: A diagnosis of bacterial meningitis in childhood recorded in the National Patient Register.

Main outcomes and measures: Annual taxable earnings (in 2020 US dollars), work loss (sum of sick leave and disability insurance), and educational attainment.

Results: The cohort included 2534 individuals diagnosed with bacterial meningitis in childhood (mean [SD] age at diagnosis, 4.7 [5.3] years) and 22 806 comparators (13 510 [53.3%] male). Among those with childhood bacterial meningitis, 812 (32.0%) were diagnosed at younger than 1 year and 1351 (53.3%) were male. From 18 to 34 years of age, those with childhood meningitis had lower adjusted earnings relative to comparators and higher adjusted work loss. When pooling observations for individuals 28 years or older, the annual mean reduction in earnings was -$1295 (95% CI, -$2587 to -$4), representing a 4.0% (95% CI, 0%-8.0%) reduction relative to comparators, and the annual increase in work loss was 13.5 (95% CI, 8.6-18.5) days. There was a larger reduction in earnings for those with childhood meningitis relative to comparators with pneumococcal (Streptococcus pneumoniae) vs meningococcal (Neisseria meningitidis) meningitis. For work loss, there was a difference among all 3 major causes of meningitis, with the largest increase for pneumococcal meningitis. Individuals diagnosed at a younger age (below the median) had lower earnings relative to comparators and higher work loss than individuals diagnosed at an older age (above the median). Fewer individuals with childhood meningitis relative to comparators had obtained a high school degree at age 30 years (adjusted odds ratio, 0.68 [95% CI, 0.56-0.81]).

Conclusions and relevance: In this cohort study of adults diagnosed with bacterial meningitis in childhood, findings suggest that work ability decreases relative to population comparators, with lower earnings and higher work loss, especially among adults diagnosed with pneumococcal meningitis or diagnosed at a young age, with long-lasting costs for the individual patient and society at large.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Mohanty reported owning stock or stock options from Merck & Co Inc during the conduct of the study. Dr Johansson Kostenniemi reported receiving funding to his institution from Merck Sharp & Dohme LLC during the conduct of the study and serving on the advisory board for pneumococcal vaccines from Merck Sharp & Dohme LLC outside the submitted work. Dr Silfverdal reported receiving grant funding to his institution from Merck Sharp & Dohme LLC during the conduct of the study and serving on the advisory board for pediatric vaccines from Merck Sharp & Dohme LLC and advisory boards of Pfizer Inc, GlaxoSmithKline, Janssen Pharmaceuticals, and Sanofi Pasteur outside the submitted work. Dr Salomonsson reported owning stock or stock options from Merck Sharp & Dohme LLC during the conduct of the study. Dr Iovino reported receiving grant funding from Merck Sharp & Dohme LLC to his institution during the conduct of the study. Dr Bencina reported owning stock or stock options from Merck Sharp & Dohme LLC during the conduct of the study. Ms Tsoumani reported owning stock or stock options from Merck Sharp & Dohme LLC during the conduct of the study. Dr Bruze reported receiving grant funding from Merck Sharp & Dohme LLC during the conduct of the study. No other conflicts were disclosed.

Figures

Figure 1.
Figure 1.. Mean Earnings and Work Loss for Individuals With Bacterial Meningitis in Childhood and General Population Comparators and the Adjusted Mean Difference Between the 2 Groups
Monetary unit is 2020 USD. C and D, Whiskers represent 95% CIs.
Figure 2.
Figure 2.. Adjusted Mean Difference Between Individuals With Bacterial Meningitis in Childhood and General Population Comparators for Earnings and Work Loss by Causative Bacterial Pathogen
Monetary unit is 2020 USD. Whiskers represent 95% CIs.
Figure 3.
Figure 3.. Adjusted Mean Difference Between Individuals With Bacterial Meningitis in Childhood and General Population Comparators for Earnings and Work Loss by Age at Diagnosis
Monetary unit is 2020 USD. Whiskers represent 95% CIs.
See this image and copyright information in PMC

Comment in

  • doi: 10.1001/jamanetworkopen.2024.45458

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