Abstract:
Background: Meningitis in neonates significantly burdens public health in low- and middle
income countries. However, data on treatment outcomes and factors contributing to poor prognosis
are scarce. This study aimed to assess treatment outcomes of meningitis and associated factors
among neonates treated at public hospitals in Harar, eastern Ethiopia.
Methods: A facility-based cross-sectional study was conducted involving 506 neonates who
received treatment between October 1, 2020, and October 31, 2024, at Hiwot Fana Comprehensive
Specialized University Hospital and Jugal General Hospital. Data were obtained from medical
records. Treatment outcomes were classified as "good" or "poor." Both binary and multivariate
logistic regression analyses were performed to identify factors associated with poor treatment
outcomes. A P-value of less than 0.05 and an adjusted odds ratio with a 95% confidence interval
were utilized to establish statistical significance.
Results: One hundred sixty-nine (33%) neonates had experienced poor treatment outcomes.
Delivered by vacuum (AOR=3.06, 95% CI: 1.03 to 9.05), positive culture of cerebrospinal fluid
(AOR=3.53, 95% CI: 1.45 to 8.57), cerebrospinal fluid protein more than 400 mg/dl at
admission (AOR=17.9, 95% CI: 7.95 to 40.3), cerebrospinal fluid glucose less than 10 mg/dl at
admission (AOR=3.89, 95% CI: 1.55 to 9.77), seizure at admission (AOR=5.6, 95% CI: 2.78 to
11.4), seizures during hospitalization (AOR=14.4, 95% CI: 5.85 to 35.2), presences of early onset
neonatal sepsis (AOR=3.5, 95% CI: 1.49 to 8.20), and predisposition to congenital hydrocephalus
(AOR=4.73, 95% CI: 1.46 to 15.2) were factors associated with poor outcome of treatment.
Conclusion: The study found that approximately 33% of newborns with meningitis experienced
poor treatment outcomes. Epilepsy and hydrocephalus were the most commonly observed
neurological sequelae. Several factors were associated with poor outcomes, including congenital
hydrocephalus, vacuum-assisted delivery, positive cerebrospinal fluid culture, seizures, elevated
cerebrospinal fluid protein with low glucose, and co-occurrence with early-onset neonatal sepsis.
