Meningitis: is a major cause of disability amongst Papua New Guinea children?

PURPOSE: This article is intended to focus on the need for the use of rehabilitation services, for children with meningitis in Papua New Guinea, which is one of largest developing country in The Pacific with diverse culture and landscape. Meningitis is the fifth leading disease that results in disability in the country. The first line of treatment is usually antibiotics, administration of vaccination is also recommended. Currently community based rehabilitation workers and Physiotherapist offer the rehabilitation services. There is a need for the other rehabilitation professionals and appropriate education to the CBR workers, caregivers for providing effective Rehabilitation. METHOD: Articles related to meningitis were recruited through various electronic database such as Ovid SP, MEDLINE, CINHAL, Google Scholar and HINARI and EBSCOhost for full text. The search includes journal articles, editorials, research reports, systematic reviews and books. RESULTS: The neurological sequelae resulting from meningitis are increasing. There is a need for Hib vaccination to reduce the rate of mortality. Physiotherapists are new professionals that emerged since 2006 and are assisting in reducing the motor and neurological disability. CONCLUSIONS: A multidisciplinary approach is required to manage the child with meningitis. Adequate knowledge, resources and assistance about the condition among the health professionals, carers and teachers would enable the children to achieve the quality of life.

Auditory performance and central auditory processing after cochlear implantation in patients deafened by meningitis.

The objective of this study was to describe the auditory performance of patients deafened by meningitis in closed-set, open-set and language tests (Luria's test). Ten paediatric subjects deafened by meningitis were compared with a peer group of ten paediatric congenitally deaf subjects. All the subjects had a full insertion of a Nucleus device. Three of the subjects in each group had a longer follow-up period and were selected to perform the Luria test. The closed-set tests did not show statistically significant differences between the two groups (p < 0.21) but comparative results of open-set bisyllabic tests did show statistically significant differences (p < 0.003). It was concluded that meningitis might affect the central auditory processing and acquisition process of language.

[Local low pressure in rehabilitation of patients with meningitis]. / Ispol'zovanie lokal'nogo ponizhennogo davleniia dlia reabilitatsii bol'nykh, perenesshikh meningit.

We studied the validity and effectiveness of interrupted local negative pressure (ILNP) in rehabilitation of patients who had had acute meningitis. ILNP on the lower part of the body was applied in 28 meningitis convalescents having residual manifestations detected at tetrapolar rheography and psychovegetative testing. As the result of the treatment the patients felt better, their psychovegetative status improved, pulse blood filling of cerebral vessels increased while tonicity of microcirculation vessels diminished. Side effects of ILNP were not registered. Thus, ILNP is effective in convalescents after meningitis.

Medical, surgical and audiological complications of the first 100 adult cochlear implant patients in Birmingham.

Of the first 100 patients implanted on the Midland Cochlear Implant Programme the commonest aetiologies of deafness were idiopathic 31 per cent, meningitis 28 per cent and cochlear otosclerosis 16 per cent. The major complication rate was three per cent. The most severe was one individual who post-operatively developed a cerebral infarct and subsequently died. The minor complication rate was 39 per cent, all of which successfully resolved, and included 11 cases of wound infection, nine cases of vertigo, three transient facial palsies and two post-operative bleeds. Older patients and men were most likely to have a post-operative medical complication. Women were more likely to have an abnormal electrode insertion. Meningitis and otosclerosis were the most complicated aetiologies in terms of cochlear ossification and electrode insertion. A non-patient cochlea was associated with fewer active electrodes. In six cases which had been reported pre-operatively as showing patent cochleas, some form of obstructional ossification was encountered. Patients functioning with greater than 15 active electrodes performed better on auditory tests than patients with fewer than 15 active electrodes.

Swallowing difficulties and early CNS injuries: correlation with the presence of axial skeletal deformities.

We reviewed the neurological findings in 36 adults with history of perinatal brain injury that required gastrostomy due to progressive swallowing difficulties in a population of 624 institutionalized patients. A stereotypic pattern of progression of deficits was observed. Risk factors that correlated with increased risk of swallowing disorders included: presence of multiple handicaps; progressive deformities of the spine and extremities; decreased range of motion of mandible, laterognathism and other mandibular asymmetries. These findings suggest that spinal deformities and swallowing difficulties are part of a spectrum of impaired function of paired axial muscles in this population. The identification of these risk factors may help in the long-term care plan of severely impaired patients whose survival is extended by the use of feeding tubes.

Reabilitaçäo nas meningites: análise de 176 casos / Rehabilitation in meningitis: analysis of 176 cases

No período de maio de 1987 a junho de 1989 foram estudados 176 pacientes internos com diagnóstico de meningite, encaminhados ao setor de Reabilitaçäo do I.E.I.S.S. Foi realizada análise quanto ao sexo, faixa etária, etiologia e tipos de sequelas. Observou-se predomínio do sexo masculino e da faixa etária de 0 a 1 ano. O maior número de casos atendidos foi de etiologia inespecífica. Dentre os pacientes atendidos foram encontrados em 53% sequelas motoras, 10% sequelas respiratórias, 36% sequelas motoras e respiratórias, e 4% somente complicaçöes articulares. De acordo com as avaliaçöes (fisiátrica e fisioterápica) teve início o acompanhamento a nível de CTI e/ou enfermaria, com atendimento diário até a alta hospitalar. O tratamento inclui desde orientaçäo nos cuidados de enfermagem e posicionamento no leito até a cinesioterapia motora e respiratória, bem como o uso de medidas anti-espásticas, farmacológicas e físicas, para normalizaçäo do tônus. Os resultados foram muito satisfatórios, atuando na profilaxia e na recuperaçäo total ou parcial das sequelas existentes