Emergency Medicine

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Browsing Emergency Medicine by Subject "Acute bacterial meningitis"

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    Treatment Outcomes and Associated Factors of Acute Bacterial Meningitis Among Children Admitted to Pediatric Emergencies of Selected Public Hospitals in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2025-06-24) Mekrez Tadesse; Wagari Tuli; Birhanu Melaku
    Background: Acute bacterial meningitis remains a major health challenge among children under five in sub-Saharan Africa, including Ethiopia, where mortality ranges from 15% to 32.65%. Despite expanded immunization programs, delayed treatment, limited diagnostic capacity, and resource constraints contribute to poor outcomes. This study assessed treatment outcomes and associated factors of acute bacterial meningitis among children in public hospitals in Addis Ababa, highlighting gaps in treatment protocols and resource allocation. Objective: Evaluate treatment outcomes and associated factors of acute bacterial meningitis among children admitted to pediatric emergencies in selected public hospitals in Addis Ababa from January 1, 2024, to December 31, 2024. Methods: A multicenter retrospective study was conducted across five public hospitals. All children aged 0–12 years diagnosed with ABM during the study period were eligible. A total of 303 patient charts were selected through simple random sampling. Data on demographics, clinical presentation, treatment, and outcomes were collected using a structured questionnaire. Used SPSS 30 to do logistic regression to identify factors associated with treatment outcomes, with findings summarized in tables and figures. Results: Of the 303 children with Acute bacterial meningitis, 71% had good outcome, while 29% had poor outcomes: 11% mortality, 14% complications, and 4% self-discharge. Significant factors associated with poor outcomes included rural residence (AOR = 5.61; 95% CI: 1.60 19.67), seizures (AOR = 0.17; 95% CI: 0.04–0.73), altered consciousness (AOR = 0.02; 95% CI: 0.003–0.10), delayed hospital presentation ≥72 hours (AOR = 0.05; 95% CI: 0.01–0.21), comorbidities (AOR = 0.19; 95% CI: 0.05–0.66), and hospital stay <7 days (AOR = 12.75; 95% CI: 1.00–162.42). Diagnostic limitations were noted: CSF analysis was performed in 56% of cases, CSF culture in 33% (8% positive). Ceftriaxone was the most prescribed antibiotic (51%), and corticosteroids were used in only 31% of cases. Conclusions: Most patients had good outcomes, but a considerable amount experienced poor outcomes, including death, complications, or leaving the hospital before completing treatment. The findings of this study suggest the need to improve early access to care, especially for rural patients, enhance diagnostic practices, and ensure consistent use of evidence-based treatments to improve outcomes for children with bacterial meningitis.