Treatment outcome and determinant factors of bacterial meningitis at pediatric ward: a multicenter study from Northwest Ethiopia

Meningitis is a serious health condition with varied treatment outcomes that can be affected due to a difference in demographic factors, clinical conditions, and treatment associated factors. The following study assess the factors to identify predicting factors for affecting the treatment outcomes. The study was done on 423 patients with meningitis retrospectively through chart review on selected hospitals from September 2022 to February 2023. The information obtained from the patient chart including demographic information, clinical state and comorbid conditions were analyzed. Logistic regression was used to identify factors associated with treatment outcomes. The larger proportion of patients (79.2%) were with the age of ≥ 2 months, with males account 52.5% of all study participants. The most common symptoms experienced by the patients were fever (85.8%), irritability (63.1%), and neck rigidity (71.2%). More than half of the participants (57.9%) has a minimum of one comorbid health condition, with pneumonia being the most prevalent comorbid disease (20.6%). In terms of treatment considered, gentamycin (31.9%) and ampicillin (31.1%) were frequently indicated, whereas antibiotic regimen changes were required in 31.9% of meningitis patients. The majority of the patients (75.7%) showed good outcomes with improvement, nevertheless around 24.3% experienced poor outcomes, including death (2.1%) and extended length of stay in hospitals (5.9%). Predicting factors for poor outcomes like delayed access to treatment initiation (Adjusted Odds Ratio (AOR = 4.24, p = 0.001)), existence of comorbidities (AOR = 4.21, p < 0.001), and absence of dexamethasone use (AOR = 2.33, p = 0.002). Though many patients presented with good treatment outcomes, lately seeking treatment options, the presence of comorbid conditions significantly affects the prognosis. The study findings indicated that early diagnosis and efficient treatment strategies of comorbid conditions and proper use of combined therapies such as dexamethasone meaningfully improve the treatment outcomes.