TY - JOUR
T1 - Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis
AU - Roed-Petersen, Casper
AU - Omland, Lars Haukali
AU - Skinhoj, Peter
AU - Rothman, Kenneth J
AU - Sorensen, Henrik Toft
AU - Obel, Niels
PY - 2013/4/24
Y1 - 2013/4/24
N2 - Importance: To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood. Objective: To study educational achievement and economic self-sufficiency in adults diagnosed as having bacterial meningitis in childhood. Design, Setting, and Participants: Nationwide population-based cohort study using national registries of Danish-born children diagnosed as having meningococcal, pneumococcal, or Haemophilus influenzae meningitis in the period 1977-2007 (n=2784 patients). Comparison cohorts from the same population individually matched on age and sex were identified, as were siblings of all study participants. End of study period was 2010. Main Outcomes and Measures: Cumulative incidences of completed vocational education, high school education, higher education, time to first full year of economic self-sufficiency, and receipt of disability pension and differences in these outcomes at age 35 years among meningitis patients, comparison cohorts, and siblings. Results: By age 35 years, among persons who had a history of childhood meningococcal (n=1338), pneumococcal (n=455), and H influenzae (n=991) meningitis, an estimated 11.0% (41.5% vs 52.5%; 95% CI, 7.3%-14.7%), 10.2% (42.6% vs 52.8%; 95% CI, 3.8%-16.6%), and 5.5% (47.7% vs 53.2%; 95% CI, 1.9%-9.1%) fewer persons, respectively, had completed high school and 7.9% (29.3% vs 37.2%; 95% CI, 1.6%-14.2%), 8.9% (28.1% vs 37.0%; 95% CI, 0.6%-17.2%), and 6.5% (33.5% vs 40.0%; 95% CI, 1.4%-11.6%) fewer had attained a higher education compared with individuals from the comparison cohort. Siblings of meningococcal meningitis patients also had lower educational achievements, while educational achievements of siblings of pneumococcal and H influenzae meningitis patients did not differ substantially from those in the general population. At end of follow-up, 3.8% (90.3% vs 94.1%; 95% CI, 1.1%-6.5%), 10.6% (84.0% vs 94.6%; 95% CI, 5.1%-16.1%), and 4.3% (90.6% vs 94.9%; 95% CI, 2.0%-6.6%) fewer meningococcal, pneumococcal, and H influenzae meningitis patients were economically self-sufficient and 1.5% (3.7% vs 2.3%; 95% CI, -0.2% to 3.2%), 8.7% (10.0% vs 1.3%; 95% CI, 5.0%-12.4%), and 3.7% (6.2% vs 2.5%; 95% CI, 1.6%-5.8%)more received disability pension compared with individuals from the comparison cohort. Conclusions and Relevance: In a Danish population, bacterial meningitis in childhood was associated with lower educational achievement and economic selfsufficiency in adult life. This association may apply particularly to pneumococcal and H influenzae meningitis, whereas for meningococcal meningitis the lower educational achievement may be family-related.
AB - Importance: To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood. Objective: To study educational achievement and economic self-sufficiency in adults diagnosed as having bacterial meningitis in childhood. Design, Setting, and Participants: Nationwide population-based cohort study using national registries of Danish-born children diagnosed as having meningococcal, pneumococcal, or Haemophilus influenzae meningitis in the period 1977-2007 (n=2784 patients). Comparison cohorts from the same population individually matched on age and sex were identified, as were siblings of all study participants. End of study period was 2010. Main Outcomes and Measures: Cumulative incidences of completed vocational education, high school education, higher education, time to first full year of economic self-sufficiency, and receipt of disability pension and differences in these outcomes at age 35 years among meningitis patients, comparison cohorts, and siblings. Results: By age 35 years, among persons who had a history of childhood meningococcal (n=1338), pneumococcal (n=455), and H influenzae (n=991) meningitis, an estimated 11.0% (41.5% vs 52.5%; 95% CI, 7.3%-14.7%), 10.2% (42.6% vs 52.8%; 95% CI, 3.8%-16.6%), and 5.5% (47.7% vs 53.2%; 95% CI, 1.9%-9.1%) fewer persons, respectively, had completed high school and 7.9% (29.3% vs 37.2%; 95% CI, 1.6%-14.2%), 8.9% (28.1% vs 37.0%; 95% CI, 0.6%-17.2%), and 6.5% (33.5% vs 40.0%; 95% CI, 1.4%-11.6%) fewer had attained a higher education compared with individuals from the comparison cohort. Siblings of meningococcal meningitis patients also had lower educational achievements, while educational achievements of siblings of pneumococcal and H influenzae meningitis patients did not differ substantially from those in the general population. At end of follow-up, 3.8% (90.3% vs 94.1%; 95% CI, 1.1%-6.5%), 10.6% (84.0% vs 94.6%; 95% CI, 5.1%-16.1%), and 4.3% (90.6% vs 94.9%; 95% CI, 2.0%-6.6%) fewer meningococcal, pneumococcal, and H influenzae meningitis patients were economically self-sufficient and 1.5% (3.7% vs 2.3%; 95% CI, -0.2% to 3.2%), 8.7% (10.0% vs 1.3%; 95% CI, 5.0%-12.4%), and 3.7% (6.2% vs 2.5%; 95% CI, 1.6%-5.8%)more received disability pension compared with individuals from the comparison cohort. Conclusions and Relevance: In a Danish population, bacterial meningitis in childhood was associated with lower educational achievement and economic selfsufficiency in adult life. This association may apply particularly to pneumococcal and H influenzae meningitis, whereas for meningococcal meningitis the lower educational achievement may be family-related.
U2 - 10.1001/jama.2013.3792
DO - 10.1001/jama.2013.3792
M3 - Journal article
SN - 0098-7484
VL - 309
SP - 1714
EP - 1721
JO - J A M A: The Journal of the American Medical Association
JF - J A M A: The Journal of the American Medical Association
IS - 16
ER -