A prospective investigation of the long-term auditory-neurological sequelae associated with bacterial meningitis: a study from Vanuatu

Abstract

During the period August 1988-July 1991 all cases of bacterial meningitis admitted to Lenakel Hospital on the island of Tanna in Vanuatu were followed. During this period there were 83 cases of purulent meningitis giving an annual incidence of 134 per 100,000 population. There were 13 deaths during the acute illness phase (CFR = 15.7%). Of the 70 survivors 65 (93%) were successfully followed for a mean duration of 17.5 months. When grouped by severity of illness there was no significant difference in the mean age, duration of symptoms or sex of the patients. At the time of discharge 31.5% had auditory-neurological abnormalities. During follow-up 35% of the survivors were found to have one or more auditory-neurological sequelae. Hearing loss was the most frequent abnormality occurring in 32.2% of the study group. Of those with auditory-neurological sequelae 39% were judged to have severe disabilities likely to impair their ability to live independently. A statistically significant association was found between the severity of the illness at presentation and the risk of auditory-neurological sequelae. Meningitis caused by Streptococcus pneumoniae was associated with the highest incidence of sequelae and that caused by Hemophilus influenzae type b with the lowest. There was no association with sex or age group. Strategies to reduce the mortality and morbidity from bacterial meningitis in developing countries are briefly discussed.