Treatment outcome and associated factors of pyogenic meningitis among children at Hawassa University comprehensive specialized hospital: a retrospective cross-sectional study

Abstract Background In Ethiopia, little is known about short-term treatment outcomes of bacterial meningitis and its associated factors among hospitalized children. This study aimed to assess the magnitude and predictors of unfavourable treatment outcome among these group. Methods A five-year retrospective study was conducted from September 2020 to August 2024 at Hawassa University Comprehensive Specialized Hospital. All children aged 1 month–14 years diagnosed with pyogenic meningitis and admitted to the pediatric ward or emergency department were included. Data were collected from medical charts using a structured tool. Statistical analyses were performed using SPSS v26, with binary logistic regression to identify factors associated with treatment outcomes. Statistical significance was declared at p < 0.05. Result Among 203 patients, 67 (33%; 95% CI 26%, 40%) had unfavourable outcomes: 29 (14.3%) died, 16 (7.9%) developed acute neurologic complications, and 22 (10.8%) were discharged against medical advice. Being male [AOR: 2.87; 95% CI: 1.14, 7.17], malnourished [AOR: 5.4; 95% CI: 2.28, 12.8], incomplete vaccination [AOR: 4.64; 95%CI: 1.71, 12.5], developing aspiration pneumonia [AOR: 4.5; 95% CI: 1.1, 17.5], comatose upon presentation [AOR: 4.6; 95% CI: 1.42, 14.9] were significantly associated with unfavourable treatment outcomes. Conclusion One-third of children hospitalized with pyogenic meningitis experienced unfavourable outcomes. Malnutrition, incomplete immunization, coma on presentation, and aspiration pneumonia were key predictors. Strengthening nutrition programs and immunization coverage may reduce morbidity and mortality.