Effect of meningitis in infancy on school-leaving examination results.

OBJECTIVES: To determine whether having had meningitis in infancy adversely affects academic achievement at age 16.

METHODS: A case-control study in England and Wales of 461 teenagers who had bacterial meningitis in infancy and 289 GP matched controls recruited when the index cases were aged 5.

OUTCOME MEASURES: Comparison between index cases and controls of the type of school attended; the number of GCSE examinations attempted; the number of examinations passed (grades A*-C) and achievement in five key subjects. Assessment of examination results according to the age at which meningitis occurred. The effect of meningitis-associated disability on GCSE results.

RESULTS: 36/461 (7.8%) index cases compared with none of the controls were in special schools. Significantly more index cases (117/461 (25.4%)) than controls (19/289 (6.6%)) did not pass any GCSE examinations. Significantly more index cases (184/385 (47.8%)) than controls (59/232 (25.4%)) attending comprehensive schools failed to achieve the national educational standard of five passes at grade C. Pupils attending comprehensive schools who did not have meningitis-associated disability also passed significantly fewer GCSE examinations than the controls. The age at which meningitis had occurred was not associated with subsequent academic achievement.

CONCLUSIONS: After meningitis in infancy a quarter of survivors failed to pass any GCSE examinations; nearly half of those attending state schools did not attain the national educational standard. "Healthy" survivors of bacterial meningitis in infancy pass significantly fewer GCSE examinations than the controls. All cases of bacterial meningitis in infancy should have a full postinfection assessment and continuing supervision.