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Treatment Outcomes and Associated Factors among Children Hospitalized with Acute Bacterial Meningitis in Eastern
Fuad Adem1, Amanuel Tasew2, Ammas Siraj1
1Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Insights
Treatment outcomes for pediatric bacterial meningitis in Ethiopia show 77% success. Poor outcomes were linked to unconsciousness, delayed care, and antibiotic changes. Improving patient outcomes requires early intervention and better healthcare links.
Area of Science:
- Pediatric Infectious Diseases
- Neuroscience
- Public Health
Background:
- Bacterial meningitis is a significant cause of pediatric morbidity and mortality.
- Limited data exists on treatment outcomes for acute bacterial meningitis in Ethiopian children.
- This study addresses the knowledge gap regarding pediatric meningitis outcomes in Ethiopia.
Purpose of the Study:
- To evaluate treatment outcomes for acute bacterial meningitis in hospitalized children.
- To identify factors associated with treatment outcomes in pediatric meningitis patients.
- The study was conducted at Hiwot Fana Specialized University Hospital, Ethiopia.
Main Methods:
- A retrospective cross-sectional study design was employed.
- Data was collected from patient medical charts at a specialized university hospital.
- Logistic regression analysis identified predictors of treatment outcomes.
Main Results:
- Out of 200 children, 77% had successful treatment outcomes.
- Delayed presentation (≥72 hours) was common (64%).
- Unconsciousness (AOR 3.25), prolonged illness before admission (AOR 3.74), and antibiotic regimen changes (AOR 4.7) predicted poor outcomes.
Conclusions:
- Most pediatric meningitis patients achieved good treatment outcomes.
- Key predictors of poor outcomes include altered consciousness, delayed hospitalization, and antibiotic regimen modifications.
- Recommendations include promoting early treatment and strengthening healthcare facility linkages.
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.
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