Long-term outcome of Haemophilus influenzae meningitis in Navajo Indian children
C. T. D'Angio, R. G. Froehlke, G. A. Plank, D. J. Meehan, C. M. Aguilar, M. B. Lande and L. Hugar
Department of Pediatrics, University of Rochester, NY, USA.
OBJECTIVES: To determine the long-term neurologic, cognitive, and
educational outcomes of Navajo children who survived Haemophilus influenzae
type b meningitis. DESIGN: Retrospective cohort study, with 3.6- to
15.0-year follow-up. SETTING: Navajo Indian reservation. PARTICIPANTS:
Population-based cohort of 76 Navajo children with Haemophilus meningitis
at less than 5 years of age between 1975 and 1986, with 41 (54%) consenting
to undergo follow-up in 1990. Each case was matched to one nearest-age
sibling and one unrelated age-matched control. MAIN OUTCOME MEASURES:
Standard intelligence test scores, neurologic abnormalities, and school
performance. RESULTS: The mean IQ for cases was lower than that for
siblings (79 vs 87, P = .006) or age-matched controls (79 vs 95, P <
.001). Twenty-nine percent of cases had severe neurologic sequelae,
including mental retardation (24%), severe hearing loss (5%), cerebral
palsy (7%), and seizure disorder (12%). Eight percent of siblings (relative
risk for cases vs siblings, 8.0; P = .05) and 2% of age-matched controls
(relative risk vs cases, 10.0; P = .01) had mental retardation. No siblings
or age-matched controls had any other severe neurologic sequela.
Twenty-nine percent of cases, 23% of siblings (relative risk, 2.5; P =
.45), and 0% of age-matched controls (P = .001) required special education
services, while 42% of cases, 23% of siblings (relative risk, 3.3; P =
.10), and 11% of age-matched controls (relative risk, 4.0; P = .005) had
been retained in a grade in school. CONCLUSIONS: Navajo survivors of
Haemophilus meningitis suffer more long-term neurologic, cognitive, and
school-related disability than siblings or age-matched controls. They may
also suffer higher morbidity than Haemophilus meningitis survivors in the
general population.
