Long‐Term Outcomes Following Bacterial Meningitis in Childhood: A Systematic Review and Meta‐Analysis

INTRODUCTION: This study conducted a systematic literature review to answer the question: "What is the frequency of post-discharge complications in patients who had bacterial meningitis during childhood and adolescence?" METHODS: Observational studies assessing post-discharge complications in patients aged 29 days to 18 years with bacterial meningitis were included. Studies on Mycobacterium tuberculosis meningitis or lacking clear diagnostic criteria were excluded. Searches were performed in July 2025 across seven databases (PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, LILACS, and BVS). Evidence certainty was assessed using GRADE. Data on events and total participants were synthesized quantitatively. RESULTS: Thirteen studies were included (sample size range: 51-3623 participants). Age at meningitis diagnosis ranged from 29 days to 18 years, with follow-up periods from 6 months to 35 years. The overall complication rate was 37.3% (95% CI 28.7-46.9). The most frequent sequelae were cognitive impairment (21.6%; 95% CI 13.2-32.8), emotional/behavioural problems (15.3%; 95% CI 8.1-26.8), and hearing loss (14.3%; 95% CI 7.7-25.1). DISCUSSION: Bacterial meningitis in childhood is associated with a significant and persistent impact on health and development. Despite heterogeneity across studies, a consistently high burden of auditory, motor, cognitive, and behavioural sequelae is observed, underscoring the need for long-term follow-up of affected individuals.