VoICE Immunization Evidence: Long term disability

Key Concept

Key Evidence: According to a review of nervous system infections, up to 50% of survivors of encephalitis caused by Japanese Encephalitis Virus (JEV) are left with permanent cognitive, psychological or neurological disabilities.

John CC, Carabin H, Montano SM, et al. 2015. Global research priorities for infections that affect the nervous system. Nature . 527.

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Key Evidence: In Gambia, 58% of children who survived a bout of pneumococcal meningitis “had clinical sequelae; half of them had major disability preventing normal adaptation to social life” (mental retardation, hearing loss, motor abnormalities, seizures).

Goetghebuer, T., West, T.E., Wermenbol, V., et al 2000. Outcome of meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae type b in children in The Gambia. Tropical Medicine and International Health. 5(3):207-13.

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Key Evidence: A systematic literature review analyzing data from 21 African countries revealed that bacterial meningitis is associated with high case fatality and frequent neurophysiological sequelae. Pneumococcal and Hib meningitis contribute to one third of disease related mortality. They also cause clinically evident sequalae in 25% of survivors prior to hospital discharge. The three main causes of bacterial meningitis- Haemophilus influenzae type B; Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are vaccine preventable, routine use of conjugate vaccines have potential for significant health and economic benefits.

From the VoICE Editors: Neuropsychological sequelae includes hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delays/impairment, and seizures. 

Ramakrishnan, M., Ulland, A.J., Steinhardt, L.C., et al 2009. Sequelae due to bacterial meningitis among African children: a systematic literature review. BMC Medicine. 7:47.

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Key Evidence: A systematic literature review of studies of the long-term effects of invasive meningococcal disease in high-income countries found that children who survived the disease had a greater incidence of hearing loss and psychological problems, including attention-deficit/hyperactivity disorder (ADHD) than control groups or the general population. In addition, they had increased odds of death – one study showed more than a 25% greater mortality rate in this population than did the general public up to 30 years after having the disease.

Strifler L, Morris SK, Dang V et al. 2015. The health burden of invasive meningococcal disease: a systematic review. Journal of the Pediatric Infectious Diseases Society. 5(4).

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