Discussion
CSF infection, cognitive impairment, meningitis, CABM, hearing impairment, headache, p<0.10, meningitis-related headache, unfavourable disability
HEARING IMPAIRMENT, MENINGITIS, DISORDERS, TUBERCULOUS MENINGITIS
In the present study, we showed that sequelae of meningitis remain common at 12 months in survivors, with more than 1 in 2 patients (53.9%) reporting incident/worsening headache and/or incident hearing impairment and/or unfavourable disability outcome. QOL scores for the physical health domain were far below the norm for the French population, with almost one in two patients (45.9%) having a quality of life score less than or equal to the 25th percentile of the general population score. Scores in other domains were comparable to those in general population [Few patients’ characteristics at the time of meningitis onset were associated with QOL at 12 months. However, it should be noted that being a woman was associated with lower physical and mental health QOL and being unemployed at meningitis onset was a predictor of lower QOL related to social relationships and environment. The impact of female gender on impaired QOL has already been shown in the literature [Some patients’ characteristics at meningitis onset are important to consider as they affect mid-term QOL. However, these factors explain only a small part of the QOL’s variance, and thus, they are not sufficient predictors of altered mid-term QOL. Then, systematic clinical follow-up of all patients should be carried out in order to anticipate and prevent the repercussions of meningitis on daily life.The month-12 CABM disability outcome score (GOS) was the major determinant of the four QOL’s domains. Almost one third of patients had an unfavourable disability outcome in our study at 12 months, which was however lower than rates reported by other studies [Our study has shown an interesting association between headache (incident or worsening since meningitis) and CABM patients’ psychological health (p = 0.010) and physical health (p<0.10). We suppose that meningitis-related headache could be caused by cerebrospinal fluid (CSF) dynamics disorders. Actually, a prospective observational study found that CSF infection (CSF protein >2.5 g/l) (p<0.001) was significantly associated with the severity of headache in tuberculous meningitis [The prevalence rate of hearing impairment in our study of 28% is comparable to that found in other studies in the literature [In addition to our study, concerning other impairments due to meningitis, cognitive impairment was reported as impacting CABM patients QOL in a Dutch study [