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J Infect. 2010 Jul;61(2):114-24. doi: 10.1016/j.jinf.2010.04.008. Epub 2010 Apr 28.

The risk of sequelae due to pneumococcal meningitis in high-income countries: a systematic review and meta-analysis.

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  • 1Modelling and Economics Unit, Health Protection Agency Centre for Infections, London, UK. mark.jit@hpa.org.uk

Abstract

OBJECTIVES:

To determine the risk of various kinds of sequelae in survivors of meningitis due to Streptococcus pneumoniae, as well as the influence of co-factors such as study design, study population and treatment on this risk.

METHODS:

MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1 September 1991 to 18 June 2009 for original articles on pneumococcal meningitis sequelae. Prevalence of sequelae was pooled using random effects meta-analysis. Studies were appraised for the influence of referral bias, external validity of study populations, testing procedure and publication bias.

RESULTS:

Data were extracted from 63 studies involving 3408 pneumococcal meningitis survivors. The pooled prevalence of any reported sequelae from 48 studies was 31.7% (95% confidence interval 27.2-36.3%) using a random effects model (Cochran-Q = 277, p < 0.01). Differences in studies due to design, study population and treatment were not significant. The pooled prevalence of hearing loss, seizures, hydrocephalus, spasticity/paresis, cranial nerve palsies and visual impairment was 20.9% (17.1-24.7%), 6.5% (3.3-9.7%), 6.8% (3.3-10.2%), 8.7% (6.4-11.0%), 12.2% (5.3-19.1%) and 2.4% (0-5.7%) respectively.

CONCLUSIONS:

The burden of sequelae due to pneumococcal meningitis remains high in the reviewed studies.

PMID:
20433866
DOI:
10.1016/j.jinf.2010.04.008
[PubMed - indexed for MEDLINE]
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