INCIDENCE AND PREDICTOR OF MORTALITY AMONG PEDIATRICS DIAGNOSED WITH CLINICAL MENINGITIS IN PUBLIC HOSPITALS IN HARAR TOWN, EASTERN ETHIOPIA

Abstract

Meningitis remains the major public health problem and a major cause of mortality and morbidity in patients in many countries of the world including Ethiopia. It needs timely diagnosis, appropriate treatment, and prevention. However, despite all effort at national and international level, still the incidence and mortality of meningitis is high with substantial burden in low- and middle- income country including Ethiopia and there was limited evidence about the incidence, and mortality of clinical meningitis among patients admitted due to diagnosis of clinical meningitis in our country including this study setting. Objectives: To estimate the incidence and determine predictor of mortality among pediatrics diagnosed with clinical meningitis in Public Hospitals in Harar Town, Ethiopia from January 1,2019 to May 30,2024. Method: An institution-based retrospective follow up-study was conducted among 600 pediatric diagnosed with clinical meningitis patients attended public hospitals in Harar town, Eastern Ethiopia. samples were selected proportionally to the hospitals number of patients. The structured checklist was used to extract the data registered on patients’ medical records. The difference in mortality risk was displayed by Kaplan-Meir, and the differences were quantified by a log-rank test. Both bivariable and multivariable Exponential proportional hazard parametric survival regression models were fitted to identify predictors of mortality of pediatric clinical meningitis patients. P-value<0.05 and Adjusted Hazard Ratio (with 95% Confidence interval) were used to declare statistical significance and predictors, respectively. Results: Out of 600, 585 (97.5%) medical charts of pediatrics diagnosed with clinical meningitis were reviewed in the study. Of these, Mortality rate was 13% (95% CI, (10 -15)). Mortality rate was increased with being dyspnea (Adjusted Hazard Ratio=3.59, 95% CI (1.33-9.71)), Hyperglycemia (Adjusted Hazard Ratio = 1.97 , 95 % CI (1.02-3.8)), Glasco coma scale 7 (Adjusted Hazard Ratio =1.03, 95% CI (5.54- 2.15)), Glasco coma scale 7-10 (Adjusted Hazard Ratio =8.25, 95% CI (4.14-16.44)), Not Vaccinated (Adjusted Hazard Ratio =3.77, 95% CI (1.66-8.58)) and partially vaccinated (Adjusted Hazard Ratio = 2.71, 95% CI (1.07 – 6.83)), season of admission in winter (Adjusted Hazard Ratio =2.23,95% CI (1.05-4.72)) and admission in summer (Adjusted Hazard Ratio =2.07, 95% CI(1.006-4.28)). Conclusion: In this study mortality rate was high. Admission at winter and summer season, dyspnea, altered mental status, high Random blood sugar, partially and not vaccinated and hypovolemic shock were predictor of mortality in pediatrics diagnosed with clinical meningitis. Thus, early recognition and management of identified predictor will have a paramount importance to enhance recovery of patients.