Clinical Predictors of Acute Bacterial Meningitis in Children Presenting with Fever and Convulsions in Bida, Niger State, Nigeria

A bstract Background: Past attempts at defining the clinical predictors of acute bacterial meningitis (ABM) have not yielded any consensus. Objective: This study aimed to identify the clinical predictors of ABM in children aged 1 month to 14 years, presenting with fever and convulsion in Bida. Materials and Methods: This was a cross-sectional, analytic study done between December 2022 and November 2023 at the Children’s Emergency unit of the Federal Medical Centre, Bida. Children who presented with fever and convulsion(s) were recruited consecutively. Socio-demographic characteristics and clinical features were obtained from each study participant. Cerebrospinal fluid was analyzed for Gram staining, culture, and sensitivity. The diagnostic value of the significant clinical parameters was investigated by determining their likelihood ratios (LRs) for meningitis. Variables with odd ratios greater than one at P < 0.05 were regarded as independent clinical predictors of ABM. Results: Of the 110 study participants, 6.4% had confirmed ABM. Age, vaccination status, bulging fontanel, level of consciousness, signs of meningeal irritation, and hyperreflexia significantly predicted ABM. Age, vaccination status, signs of meningeal irritation, and level of consciousness had a positive likelihood for ABM (LRs: 9.433, 16.514, 11.392, and 4.238, respectively). Only age (OR – 0.212, 95% CI: 0.052–0.853, P = 0.029), vaccination status (OR – 10.640, 95% CI: 1.72–64.978, P = 0.010), and signs of meningeal irritation (OR – 0.026, 95% CI: 0.003–0.205, P = 0.001) were independent and significant predictors of ABM on regression analysis. Conclusion: Significant predictors of meningitis were meningeal irritation, vaccination status, and age less than 12 months.