Hearing Loss at School Age in Survivors of Bacterial Meningitis: Assessment, Incidence, and Prediction

• Published in: Pediatrics (Evanston) Vol. 112; no. 5; pp. 1049 - 1053
• Main Authors: Koomen, Irene, Grobbee, Diederick E, Roord, John J, Donders, Rogier, Jennekens-Schinkel, Aag, van Furth, A. M
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL Am Acad Pediatrics 01-11-2003; American Academy of Pediatrics
• Subjects: Adolescent; Ataxia - epidemiology; Ataxia - etiology; Biological and medical sciences; Child; Cohort Studies; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Follow-Up Studies; General aspects; Glucose - cerebrospinal fluid; Hearing loss; Hearing Loss, Bilateral - epidemiology; Hearing Loss, Bilateral - etiology; Hearing Loss, Sensorineural - epidemiology; Hearing Loss, Sensorineural - etiology; Human infectious diseases. Experimental studies and models; Humans; Incidence; Infectious diseases; Male; Medical sciences; Medical screening; Meningitis; Meningitis, Bacterial - complications; Netherlands - epidemiology; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pediatrics; Purpura - epidemiology; Risk Factors; Survivors; Netherlands; Pediatrics; hearing assessment; Survivor; Prediction; Auditory disorder; hearing impairment; Epidemiology; Incidence; Hearing loss; Hearing; School age; Bacterial meningitis; Cohort study; ENT disease; Predictive factor; Public health
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.112.5.1049

To establish the incidence of sensorineural hearing loss in children who survived non-Haemophilus influenzae type B (Hib) bacterial meningitis, to highlight the actual percentage whose hearing was evaluated, and to develop a prediction rule to identify those who are at risk of hearing loss.
In 1999, we compiled a cohort of 628 school-aged children who were born between January 1986 and December 1994 and had survived non-Hib bacterial meningitis between January 1990 and December 1995. Presence of sensorineural hearing loss (>25 dB) was determined, based on information from questionnaires and medical records. Potential risk factors for hearing loss were obtained from medical records; independent predictors were identified using multivariate logistic regression analysis, leading to the formulation of a prediction rule.
The incidence of hearing loss was 7%. The hearing of 68% of the children was evaluated as part of their routine follow-up after bacterial meningitis, resulting in the detection of 75% of the cases of hearing loss. The remaining 25% were detected after this follow-up had ended. Using a prediction rule based on 5 factors-duration of symptoms before admission >2 days, absence of petechiae, cerebrospinal fluid glucose level <or=0.6 mmol/L, Streptococcus pneumoniae, and ataxia-62% of the postmeningitic children were selected as being at risk. All cases of hearing loss were in this at-risk group.
Hearing loss can be predicted satisfactorily. When the hearing of children who are predicted to be at risk is tested as part of their routine follow-up, no children with hearing loss need be missed.