Treatment Outcomes and Associated Factors among Children Hospitalized with Acute Bacterial Meningitis in Eastern Ethiopia: A Cross-Sectional Study

Abstract

Background Bacterial meningitis is a common central nervous system infection that is associated with high morbidity and mortality in pediatrics. In Ethiopia, little is known about treatment outcomes of acute bacterial meningitis and associated factors among hospitalized children. Objective To assess treatment outcomes of acute bacterial meningitis and associated factors among hospitalized children with acute bacterial meningitis in the Hiwot Fana Specialized University Hospital pediatric ward. Methods A retrospective cross-sectional study was conducted at the pediatric ward of Hiwot Fana Specialized University Hospital, eastern Ethiopia. Relevant data were collected using a structured data-collection tool from patients’ medical charts. Bivariate and multivariate logistic regression analyses were done to identify predictors of treatment outcomes. OR with 95% CI and P ≤0.05 was used for statistical significance. Results A total of 200 children with acute bacterial meningitis were included in the study, of which 92% were aged ≥2 months and the majority (128, 64%) had delayed (≥72 hours) presentation to the hospital. At admission, 181 (90.5%) were febrile, 92 (46%) had depressed level of consciousness, and 40 (20%) had had seizures. Most (126, 63%) had documented medical comorbidities. The antibiotic combination of ampicillin and gentamycin had been frequently administered in children aged <2 months while ceftriaxone was commonly prescribed for those aged >2 months. Of the total study participants, 154 (77%) showed successful treatment outcomes, while 46 (23%) experienced poor treatment outcomes (died or “self”-discharged). Level of consciousness (AOR 3.25, 95% CI 1.21–8.75), duration of illness before admission (AOR 3.74, 95% CI 1.76–7.98), and antibiotic-regimen change (AOR 4.7, 95% CI 2.4–10) were predictors of treatment outcomes. Conclusion The majority of study participants experienced good treatment outcomes. Unconsciousness, antibiotic-regimen change, and duration of illness before hospitalization were significantly associated with treatment outcomes. Early treatment, linkage of primary-health facilities to tertiary health–care centers, and availability of diagnostics should be promoted to improve patient outcomes.

Treatment outcome and associated factors of bacterial meningitis at pediatric wards of southwestern Ethiopian hospital: a prospective observational study

“…Besides this, the patient was followed by a neurosign chart that includes vital signs, bulging fontanelle, photophobia, a positive Kernig’s or Brudzinski’s sign, seizure, headache, and nuchal rigidity. The outcome of the patients and the presence of the complications among pediatrics were evaluated during their hospital stay [ 2 ].…”

“…Meningitis is one of the most common types of central nervous system (CNS) infection and it is an inflammation of the meninges; that involves the subarachnoid space or spinal fluid [ 1 , 2 ]. Definitive diagnosis of acute bacterial meningitis (ABM) is often dependent on cerebrospinal fluid (CSF) detail report and its culture by performing lumbar puncture [ 3 ].…”

“…The region in Sub- Saharan Africa, including Ethiopia, is known as the “meningitis belt” because of the high prevalence of meningitis in the area [ 2 , 4 ]. More than one million cases of acute bacterial meningitis (ABM) amongst adults and children occur annually in sub-Saharan Africa (SSA) [ 5 ].…”

“…It is a common infectious cause of morbidity and mortality in pediatric age-groups [ 7 ]. Each year, it affects about 2.81 million children, especially < 5 years of age [ 2 ]. Meningitis is one of the top ten causes of death among Ethiopian infants [ 8 ].…”

“…Bacterial meningitis is one of the most potentially serious infections occurring in infants and children [ 1 ]. About one third of meningitis patients developed complications like hearing impairment, seizure disorders, developmental delays and learning and behavioral problems [ 2 , 9 ].…”