Meningitis is the inflammation of the membranes surrounding and protecting the brain and the spinal cord. In most cases, it is caused by an infection, although non-infectious causes are also not uncommon. Meningitis is a major global burden of disease: according to the World Health Organization, it is associated with an estimated 171,000 deaths and 9.8 million disability-adjusted life years worldwide.
There is also increasing clinical and research attention given to the long-term implications of meningitis. While there has been an extensive body of research on cognitive difficulties in survivors of childhood meningitis, most studies have only considered meningitis survivors with or without serious complications as a single group. Furthermore, estimation of the burden of meningitis has most commonly involved data on mortality and the cost of disability resulting from serious complications. Therefore, relatively little is known about the burden of cognitive and psychological difficulties in survivors who appear to be neurologically healthy.
Dr Golam Khandaker, a clinical lecturer in the Department of Psychiatry and member of the EpiCentre group led by Professor Peter Jones, conducted a 12-year follow-up study of individuals who suffered meningitis in the first 18 months of life. The researchers used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a general population birth cohort. The follow-up period in this study is longer than in previous studies, and this study is one of the first in the prevailing literature to focus exclusively on meningitis survivors without a serious neurological disability. To assess individuals’ outcomes, Dr Khandakar compared neurocognitive and educational performance measures such as intelligence quotient (IQ), short-term memory, working memory, reading and spelling abilities between ages 9 – 11 as well as psychological well-being up to age 13.
The findings, recently published in the Annals of Epidemiology, revealed several insights into the educational and psychological difficulties experienced by meningitis survivors who appear to be healthy. Out of the 11035 children included in the ALSPAC birth cohort, 67 were identified to have suffered from meningitis by the age of 18 months. Compared to children who did not have meningitis, those who did performed worse across the range of cognitive and educational measures mentioned previously. In addition, meningitis was associated with psychological difficulties including depression and anxiety symptoms as well as behavioural problems during late childhood and early adolescence. Survivors were also twice as likely to report psychotic symptoms in early adolescence, which, according to the existing literature, is associated with increased risk of various mental illnesses in adult life.
The findings of this study serve to argue for the necessity of increased awareness, both within the family environment and the classrooms, to enable these children to realise their full academic potential.
Dr Khandakar said, “survivors of early-life meningitis – even those who are apparently neurologically healthy – experience various psychological and cognitive difficulties during childhood and adolescence, so increased awareness of the consequences of early-life meningitis is needed along with increased support for meningitis survivor children in school and at home“.
Written by Elijah Mak.