Acute Bacterial Meningitis Outcome and Associated Factors among Pediatric Age Group at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Abstract

Abstract Background: Acute bacterial meningitis is one of the cause of significant mortality and morbidity in pediatrics worldwide, particularly in developing countries. Delayed presentation, limited treatment options, lack of local evidence based guidelines are few among the many challenges facing developing countries in the management of bacterial meningitis. Studies are scarce in Ethiopia on the outcome of acute bacterial meningitis specially in pediatric population. Objective: To assess outcome of acute bacterial meningitis and its associated factors among pediatrics at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods: Institution based cross-sectional study was conducted on 225 pediatric patients who were admitted with the diagnosis of acute bacterial meningitis from January 1, 2013 to December 30, 2017. Data were obtained through document review from patient charts. The descriptive statistics was summarized using mean, frequency, proportion, and the associated factors affecting outcome were identified using binary logistic regression at the level of significance with p value < 0.05 and confidence interval which doesn’t include 1. Results: Among the 225 patients studied, almost a quarter of them had unfavorable outcome. Around one-tenth (8.2%) of them died and 18% of survivors had neurologic sequelae at leaving the hospital. Delayed presentation (AOR = 3.45; 95% CI = 1.40 – 8.51), coma (AOR = 14.18; 95% CI = 3.35 – 59.98), impaired consciousness (AOR = 3.88; 95% CI = 1.46 – 10.30), malnutrition (AOR = 3.19; 95% CI = 1.258 – 8.070), motor neurologic deficit at presentation (AOR = 7.38; 95% CI = 1.65 – 33.14), and no history of fever (AOR = 5.719; 95%CI = (1.473, 22.208) were found to be independent predictors of unfavorable outcome. Conclusion and recommendations: A quarter of patients admitted with acute bacterial meningitis experience unfavorable outcome at leaving the hospital. Decreased level of consciousness, presence of motor neurologic deficit at presentation, malnutrition, delayed presentation and no history of fever are found to be independent predictor for unfavorable outcome. Therefore, attention should be given for public awareness creations on impact of delay presentation, and cautious management of patients with predictors of unfavorable outcomes. Key words: Acute bacterial meningitis, outcome, pediatrics, Gondar, Ethiopia