ASSESSMENT OF TREATMENT OUTCOME AND ASSOCIATED FACTORS OF BACTERIAL MENINGITIS AT PEDIATRICS WARD IN MIZAN TEPI UNIVERSITY TEACHING HOSPITAL. SNNPR, SOUTHWEST ETHIOPIA
Keywords:Bacterial meningitis, Antimicrobial therapy, Pediatrics, Ethiopia
Objective: The aim is to assess the treatment outcome and associated factors of bacterial meningitis in the pediatric ward of Mizan Tepi University teaching hospital, southwest Ethiopia.
Methods: A retrospective cross-sectional study was conducted among pediatrics between the ages of (0 and 15 years) admitted to the Pediatric ward of MTUTH from January 1, 2015, to December 31, 2017. Data were collected through a Data abstraction checklist from March 10 to 22, 2018. Data were entered using the EPI-INFO (version 3.5.1) and then transferred to SPSS (version 21) for the analysis, and bivariate analysis was performed for all independent variables, and variables with p<0.25 were selected to fit multivariate logistic regression. Finally, multivariate logistic regression was performed to determine independent predictors of poor outcomes. An odds ratio and 95% confidence interval were used, and the level of statistical significance was considered at p<0.05.
Results and Discussion: The results of this study were analyzed for 99 patients treated for acute bacterial meningitis. The most frequently used initial antibiotic regimen in young infants was ampicillin plus gentamycin (87.5%). While most of the older infants and children, 71 (78%) were initially managed with ceftriaxone. Among the treated patients, 76 (76.76%) were improved and 23 (23.23%) of them had poor outcomes (11.1% died, 9.1% Left against medical advice, and 3% were Referred to a Higher facility. The determinant factors of poor outcome of pediatrics treated for bacterial meningitis were duration of illness before hospital admission AOR=11.26, 95% CI (1.8–68), vomiting (AOR=4.9, 95%CI (1.2–19.9) and AB regimen changes (AOR=4.6, 95% CI (1.72–20.43) independent predictors of poor outcomes.
Conclusion: To conclude that, this study has shown the initial antimicrobial regimen used was almost in line with the recommendation. At discharge around 25% of the pediatric patients treated for bacterial meningitis, experienced poor outcomes, which implicates the need for more attention during treatment. Duration of illness before hospital admission most independently predicts the incidence of poor outcomes.
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