https://repositorio.fleni.org.ar/xmlui/handle/123456789/604 2026-07-01T22:09:24Z 2026-07-01T22:09:24Z Alviz, Luisa F. Kim, Carla Y. Monette, Lauren E. Harrer, Caroline E. Benevides Tadinac, Ana Claudia Roberts, Jackson A. Varela, Francisco José Hwang, Soonmyung A. Gebresilassie, Blen M. Balcarce, Pilar Prasad, Manya Usseglio, John Kothari, Kavita U. Venuti, Francesco Schiess, Nicoline Binello, Nicolò Brohan, Elaine Dua, Tarun Thakur, Kiran T. https://repositorio.fleni.org.ar/xmlui/handle/123456789/1508 2026-06-24T16:41:54Z 2026-02-28T00:00:00Z

Detection of sequelae from acute meningitis during clinical review by a healthcare provider : a systematic review and meta-analysis Alviz, Luisa F.; Kim, Carla Y.; Monette, Lauren E.; Harrer, Caroline E.; Benevides Tadinac, Ana Claudia; Roberts, Jackson A.; Varela, Francisco José; Hwang, Soonmyung A.; Gebresilassie, Blen M.; Balcarce, Pilar; Prasad, Manya; Usseglio, John; Kothari, Kavita U.; Venuti, Francesco; Schiess, Nicoline; Binello, Nicolò; Brohan, Elaine; Dua, Tarun; Thakur, Kiran T. Background: Neurological sequelae from acute meningitis are estimated to affect more than 30% of survivors worldwide, though often underreported or undetected due to inadequate follow-up, limited access to healthcare services, and diagnostic challenges. The aim of this systematic review and meta-analysis is to assess the time of administered health assessments for the detection of meningitis-related sequelae associated with acute meningitis diagnosis in adult and pediatric populations. Methods: A literature review was conducted in three databases. Studies documenting the time frame of sequelae detection after an acute episode of all-cause meningitis were included. Descriptive analysis and meta-analysis of pooled prevalence for neurological outcomes were performed, with subgroup analysis per timepoint of healthcare assessment. Results: A total of 89 studies met inclusion criteria, reporting 9311 adult and 18,658 pediatric meningitis cases. Among adults, 7301 (78.4%) underwent sequelae assessment, with 1339 (18%) diagnosed. The most frequently reported sequelae were hearing loss, followed by focal neurological deficits, psychological after-effects, neurocognitive impairments, seizures, hydrocephalus, speech disorders, vision impairment, and limb loss. While more were assessed before discharge (5270 vs. 2711), the proportion of sequelae diagnoses was higher post-discharge. The pooled prevalence of sequelae was 24.8% (95% CI 20.5-29.2%) at discharge, compared to 41.5% (95% CI 25.7-57.3%) within 3 months and 31.9% (95% CI 18.5-45.3%) beyond 3 months post-discharge. In children, 14,826 (79%) were assessed, and 3484 (24%) had sequelae, with the most common sequelae being hearing loss, followed by focal neurological deficits, seizures, neurocognitive, and neurodevelopmental impairments. More were assessed post-discharge (8298 vs. 7180), with a higher pooled prevalence of sequelae diagnoses post-discharge. At discharge, the pooled prevalence of sequelae was 28.9% (95% CI 20.8-37%), compared to 29.9% (95% CI 19-40.8%) within 3 months and 38.2% (95% CI 30.3-46.1%) beyond 3 months after discharge. Conclusions: Meningitis-related sequelae significantly impact quality of life. This review highlights variability and critical gaps in their evaluation, detection, and management, underscoring the need for routine monitoring from discharge through consistent follow-up assessments, as recommended by the new WHO guidelines on meningitis diagnosis, treatment, and care.

2026-02-28T00:00:00Z Alviz, Luisa F. Kim, Carla Y. Benevides Tadinac, Ana Claudia Roberts, Jackson A. Monette, Lauren E. Harrer, Caroline E. Varela, Francisco José Hwang, Soonmyung A. Gebresilassie, Blen M. Balcarce, Pilar Prasad, Manya Usseglio, John Kothari, Kavita U. Venuti, Francesco Schiess, Nicoline Gadama, Yohane Binello, Nicolò Chadha, Shelly Dua, Tarun Thakur, Kiran T. https://repositorio.fleni.org.ar/xmlui/handle/123456789/1504 2026-06-24T16:46:35Z 2026-02-28T00:00:00Z

Detection of hearing loss by formal audiological testing after acute infectious meningitis : a global systematic review and meta-analysis Alviz, Luisa F.; Kim, Carla Y.; Benevides Tadinac, Ana Claudia; Roberts, Jackson A.; Monette, Lauren E.; Harrer, Caroline E.; Varela, Francisco José; Hwang, Soonmyung A.; Gebresilassie, Blen M.; Balcarce, Pilar; Prasad, Manya; Usseglio, John; Kothari, Kavita U.; Venuti, Francesco; Schiess, Nicoline; Gadama, Yohane; Binello, Nicolò; Chadha, Shelly; Dua, Tarun; Thakur, Kiran T. Background Acute community-acquired bacterial meningitis remains a significant global health concern with significant mortality and morbidity, including neurological sequelae such as sensorineural hearing loss (SNHL). Early detection of meningitis-associated SNHL mitigates permanent deafness and poor outcomes, including cognitive decline, social isolation, and mental health disorders. This systematic review evaluates the optimal time point(s) to perform formal audiological diagnostic testing and follow-up in adult and pediatric meningitis patients to effectively detect hearing loss (HL) outcomes. Methods A literature search was conducted across Medline, Embase, and Cochrane databases. Studies reporting the time frames for HL detection secondary to acute meningitis using formal audiological tests were included. Data were analyzed descriptively for continuous and categorical variables. A meta-analysis calculated the pooled prevalence of outcomes, with subgroup analyses stratified by the time frame of audiological diagnostic assessment. Results A total of 41 studies were included, with n=8105 meningitis patients comprising n=1397 (17.2%) adults and 6708 (82.8%) children. In adults, most audiological testing occurred post-discharge (n=530 vs. n=145), yet the proportion of hearing loss diagnoses was higher before discharge than after (45.5% vs. 42.5%). Similarly, more audiological assessments were administered post-discharge compared to pre-discharge (n=3340 vs. n=1975) in children, but HL diagnoses were more frequent before discharge (33.9% vs. 25.3%). The pooled prevalence of HL diagnoses during hospitalization or at discharge was 30.4% (95% CI 22.9–38%), compared to 22.9% (95% CI 12.6–33.1%) within 1 month post-discharge, 20.3% (95% CI 8.8–31.9%) between 30 and 60 days post-discharge, 22.7% (95% CI 12.1–33.4%) between 60 and 180 days post-discharge, and 10.8% (95% CI 5.9–15.7%) more than 180 days after discharge. Conclusions The considerable variability in the time frame of audiological test administration following an acute meningitis episode highlights the need for standardized auditory evaluations after meningitis diagnosis. Our findings emphasize that as hearing loss may occur and recover at different stages after an infectious meningitis episode, coordinated hearing assessments at discharge and during follow-up are important to ensure adequate detection and care.

2026-02-28T00:00:00Z World Health Organization https://repositorio.fleni.org.ar/xmlui/handle/123456789/1438 2025-10-28T14:57:41Z 2025-01-01T00:00:00Z

WHO guidelines on meningitis diagnosis, treatment and care [Internet] World Health Organization In line with the Defeating meningitis by 2030: a global road map, the WHO guidelines on meningitis diagnosis, treatment and care provide evidence-based recommendations for the clinical management of children and adults with community-acquired meningitis, including acute and long-term care. Meningitis poses a significant public health threat, despite successful efforts to control the disease globally. The burden of morbidity and mortality from meningitis remains high, particularly in low- and middle-income countries and in settings experiencing large-scale, disruptive epidemics. Approximately one in five individuals affected by bacterial meningitis incurs long-term complications, which may result in disability and have a profound impact on quality of life. The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-governmental and civil society organizations to inform capacity-building, teaching and research agendas. Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.

2025-01-01T00:00:00Z Caiza-Zambrano, Francisco Aldecoa, Mayra Rugilo, Carlos Taratuto, Ana Lía Marchesoni, Cintia León-Cejas, Luciana Reisin, Ricardo Bonardo, Pablo https://repositorio.fleni.org.ar/xmlui/handle/123456789/1309 2025-03-06T14:53:16Z 2025-02-16T00:00:00Z

Adult polyglucosan body disease: ultrarare but commonly misdiagnosed Caiza-Zambrano, Francisco; Aldecoa, Mayra; Rugilo, Carlos; Taratuto, Ana Lía; Marchesoni, Cintia; León-Cejas, Luciana; Reisin, Ricardo; Bonardo, Pablo Adult polyglucosan body disease is a rare genetic condition caused by biallelic pathogenic variants in GBE-1 gene. Affected patients typically have urinary dysfunction, progressive gait disturbance and cognitive impairment. We report a 63-year-old woman with urinary incontinence, walking difficulty and episodes of forgetfulness. She had symmetrical limb weakness with upper motor neurone signs, distal sensory loss and a broad-based ataxic gait. MR scans of the brain and spine showed white matter changes with cerebellar and spinal cord atrophy. Sural nerve biopsy identified intra-axonal polyglucosan bodies. A multigene panel test identified a GBE-1 pathogenic variant, confirming the diagnosis of adult polyglucosan body disease. This case emphasises the importance of considering rare genetic disorders in people with autonomic dysfunction, mixed upper and lower motor neurone signs, peripheral neuropathy and cognitive impairment.

2025-02-16T00:00:00Z