Neurologic outcome of Filipino children diagnosed with central nervous system infection

Aida M. Salonga, National Institutes of Health, University of the Philippines Manila
Peter Francis Raguindin, National Institutes of Health, University of the Philippines Manila
Mishelle H. Imperial, Philippines Children's Medical Center
Marilyn H. Ortiz, Philippines Children's Medical Center
Martha L. Bolaños, University of the Philippines Manila
Maria Lourdes M. Trajano, Baguio General Hospital and Medical Center
Madeleine Grace M. Sosa, De La Salle Medical and Health Sciences Institute
Bernadette Chua-Macrohon, Zamboanga City Medical Center
Jo Janette R. de la Calzada, Cebu Doctors' University Hospital
Maria Lourdes E. Amarillo, University of the Philippines Manila

Abstract

© 2019, ASEAN Neurological Association. All rights reserved. Background: Neurologic infections are related to chronic and life-long neurologic impairment. We aim to describe the outcomes of Filipino children with neurologic infections upon, and within one year from discharge. This data will be useful in developing programs for the prevention and improvement of outcomes in children with neurologic infections. Methods: This is a multicenter, cross-sectional, retrospective cohort study at six tertiary hospitals across the Philippines within four years (2007-2010). A standardized report form was used to collect clinical profile and outcome using inpatient and outpatient records. Neurologic outcome was classified and staged at 3-, 6-, 9- and 12-months postdischarge. Results: A total of 480 patients were included in the analysis (mean age 4.7 ± 5.3 y), most were bacterial in etiology (275 cases, or 57.3%). Severity of illness on admission (Stage 3, p <0.001) and etiologic agent (viral, p <0.001) were correlated with poor neurologic outcome on discharge. Of the 154 patients that had follow-up, 91 cases were observed to have neurologic deficits (severe, 50; moderate, 29; and mild 12). Twenty patients had improvement of neurologic impairment on subsequent follow-up. Motor deficits (64 cases), cognitive disorders (26 cases) and seizures (17 cases) are the most common neurologic sequela. Conclusion: Outcomes of neurologic infections in children are dynamic. Close monitoring of the neurodevelopmental status after treatment is recommended to institute early intervention and rehabilitation programs that can modify the long-term outcome for children.