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细菌性脑膜炎后神经后遗症的影响与负担:一项叙述性综述

The Impact and Burden of Neurological Sequelae Following Bacterial Meningitis: A Narrative Review.

作者信息

Schiess Nicoline, Groce Nora E, Dua Tarun

机构信息

Brain Health Unit, Department of Mental Health and Substance Use, World Health Organization (WHO), 1202 Geneva, Switzerland.

UCL International Disability Research Centre, Department of Epidemiology and Health Care, University College London, London WC1E 7HB, UK.

出版信息

Microorganisms. 2021 Apr 22;9(5):900. doi: 10.3390/microorganisms9050900.

Abstract

The burden, impact, and social and economic costs of neurological sequelae following meningitis can be devastating to patients, families and communities. An acute inflammation of the brain and spinal cord, meningitis results in high mortality rates, with over 2.5 million new cases of bacterial meningitis and over 236,000 deaths worldwide in 2019 alone. Up to 30% of survivors have some type of neurological or neuro-behavioural sequelae. These include seizures, hearing and vision loss, cognitive impairment, neuromotor disability and memory or behaviour changes. Few studies have documented the long-term (greater than five years) consequences or have parsed out whether the age at time of meningitis contributes to poor outcome. Knowledge of the socioeconomic impact and demand for medical follow-up services among these patients and their caregivers is also lacking, especially in low- and middle-income countries (LMICs). Within resource-limited settings, the costs incurred by patients and their families can be very high. This review summarises the available evidence to better understand the impact and burden of the neurological sequelae and disabling consequences of bacterial meningitis, with particular focus on identifying existing gaps in LMICs.

摘要

脑膜炎后神经后遗症的负担、影响以及社会和经济成本,对患者、家庭和社区可能造成毁灭性打击。脑膜炎是脑和脊髓的急性炎症,导致死亡率很高,仅在2019年,全球就有超过250万例细菌性脑膜炎新病例,死亡人数超过23.6万。高达30%的幸存者有某种类型的神经或神经行为后遗症。这些后遗症包括癫痫发作、听力和视力丧失、认知障碍、神经运动残疾以及记忆或行为改变。很少有研究记录长期(超过五年)后果,或者分析脑膜炎发病时的年龄是否会导致不良后果。这些患者及其照顾者的社会经济影响以及对医疗随访服务的需求也缺乏相关记录,尤其是在低收入和中等收入国家(LMICs)。在资源有限的环境中,患者及其家庭产生的费用可能非常高。本综述总结了现有证据,以更好地了解细菌性脑膜炎神经后遗症的影响和负担以及致残后果,特别关注确定低收入和中等收入国家存在的差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7e8/8145552/9f46528e2881/microorganisms-09-00900-g001.jpg

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