SEQUELLES NEUROLOGIQUES CHEZ DES ENFANTS ATTEINTS D\'UNE MENINGITE PURULENTE DANS UN CENTRE TERTIAIRE A LAGOS (NIGERIA)

NEUROLOGICAL SEQUELAE IN CHILDREN WITH PYOGENIC MENINGITIS IN A TERTIARY CENTRE IN LAGOS (NIGERIA ABSTRACT Background: Neurological sequelae following childhood bacterial meningitis are common particularly in the presence of delayed diagnosis and treatment. The latter is commonplace with meningitis in developing countries like Nigeria but information on the incidence and prevalence rates of consequent neurological sequelae is rare. Objective: We herein document the prevalence of such sequelae in children following admission for pyogenic meningitis and describe associated risk factors. Methods: We retrospectively reviewed forty-nine children managed for acute pyogenic meningitis at the Lagos University Teaching Hospital (LUTH) over a 10-year period. Information on biodata, clinical features, pre–admission treatment, investigation results, treatment, and duration of hospitalization were extracted from their case records and analysed. Results: Thirty-two (65.3%) of these children had obvious neurological sequelae. These included neuro-motor disorders (31%), hydrocephalus (28%), hearing disorders (25%), speech and language problems (25%), recurrent seizures (22%), mental retardation (22%), visual defects (19%) and behavioural problems (3%). All ages were affected but more commonly infants. Sequelae occurred in multiples. Children with sequelae tended to have had prior hospitalization and treatment. However no clinical or socio-economic factors showed significant relationship with the development of neurological sequelae. Conclusions: The distribution of sequelae in our study is similar to findings of other authors but shows a higher prevalence thus further confirming the need for primary prevention of this disease and for prompt and adequate treatment of cases. We recommend early screening of survivors for sequelae so that adequate rehabilitation can be planned. RESUME Introduction: Les sequelles neurologiques secondaire a une meningite bacterienne au cours de l\'enfance sont frequentes en particulier lorsque le diagnostic et le traitement sont retardes. Objectif: Nous rapportons dans ce travail les aspects sequellaires neurologiques observes chez les enfants hospitalises pour meningite pyogenique en relevant les facteurs de risque lies a cette affection. Methode: Nous avons passe en revue retrospectivement, quarante neuf enfants traites atteints de la meningite purulante au centre hospitalier universitaire de Lagos (LUTH) au cours d'une periode de 10 ans. Les informations cliniques, paracliniques et therapeutiques tires de leurs dossiers medicaux ont ete analyses. Resultats: Trente deux soit 65,3% des cas enfants presentaient des sequelle neurologicales: troubles neuro-moteurs (31%), hydrocephalie (28%), troubles de l'ouie (25%), troubles du language et (25%), crise chronique (22%), retard mentale (22%), troubles visuelles (19%) et de comportement (3%). Aucun facteur clinique, socio-economique n'a pas ete releve et relie avec la survenue de sequelle neurologique. Conclusion: Nos resutalts sont semblabes a ceux presentes par d\'autres auteurs. La prevalence est elevee, impliquant ainsi la necessite d\'une politque de prevention de cette affection ainsi qu\'un traitement precoce et la prise en charge des enfants porteurs de sequelles Key Words: Africa, neurological sequelae, pyogenic meningitis, Afrique, meningite purulente, Nigeria, sequelles African Journal of Neurological Sciences Vol.23(2) 2004