A PROSPECTIVE INVESTIGATION OF THE LONG-TERM AUDITORY-NEUROLOGICAL SEQUELAE ASSOCIATED WITH BACTERIAL-MENINGITIS - A STUDY FROM VANUATU

During the period August 1988-July 1991 all cases of bacterial meningi tis admitted to Lenakel Hospital on the island of Tanna in Vanuatu wer e followed. During this period there were 83 cases of purulent meningi tis giving an annual incidence of 134 per 100 000 population. There we re 13 deaths during the acute illness phase (CFR=15.7%). Of the 70 sur vivors 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 patient s. At the time of discharge 31.5% had auditory-neurological abnormalit ies. During follow-up 35% of the survivors were found to have one or m ore auditory-neurological sequelae. Hearing loss was the most frequent abnormality occurring in 32.2% of the study group. Of those with audi tory-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. Menin gitis caused by Streptococcus pneumoniae was associated with the highe st incidence of sequelae and that caused by Hemophilus influenzae type b with the lowest. There was no association with sex or age group. St rategies to reduce the mortality and morbidity from bacterial meningit is in developing countries are briefly discussed.