PLoS One. 2026 Aug 11;21(8):e0355843. doi: 10.1371/journal.pone.0355843. eCollection 2026.
ABSTRACT
BACKGROUND: Meningitis in neonates remains a major public health concern, particularly in low- and middle-income countries. Despite its high morbidity and mortality, evidence on treatment outcomes and determinants of poor prognosis is limited. This study aimed to assess treatment outcomes of meningitis and its associated factors among neonates admitted to public hospitals in Harar town, Ethiopia.
METHODS: A facility-based cross-sectional study was conducted among 506 neonates diagnosed with meningitis admitted between October 2020 and October 2024. Data were extracted from medical records. Treatment outcomes were categorized as good or poor. Binary and multivariable logistic regression analyses were performed to identify factors associated with poor treatment outcomes. Statistical significance was declared at a p-value <0.05 using adjusted odds ratios (AORs) with 95% confidence intervals (CIs).
RESULTS: A total of 169 (33%) neonates experienced poor treatment outcomes. Assisted vaginal delivery (AOR = 3.70; 95% CI: 1.42-9.69), positive cerebrospinal fluid (CSF) culture (AOR = 3.74; 95% CI: 1.76-7.96), elevated CSF white blood cell count >2500 cells/mm³ (AOR = 6.10; 95% CI: 2.54-14.69), high CSF protein >400 mg/dL (AOR = 5.43; 95% CI: 2.84-10.36), low CSF glucose <10 mg/dL (AOR = 3.57; 95% CI: 1.64-7.80), seizures at admission (AOR = 5.07; 95% CI: 2.71-9.46), seizures after admission (AOR = 3.88; 95% CI: 1.82-8.25), early-onset neonatal sepsis (AOR = 4.27; 95% CI: 2.03-8.99), and non-exclusive breastfeeding (AOR = 2.20; 95% CI: 1.06-4.57) were predictor of poor treatment outcomes.
CONCLUSION: About one-third of neonates with meningitis experienced poor treatment outcomes. Factors associated with poor outcomes included assisted vaginal delivery, severe CSF abnormalities (positive culture, high white blood cell count, elevated protein, and low glucose), seizures at or after admission, early-onset neonatal sepsis, and non-exclusive breastfeeding. These findings highlight the need for early risk stratification and timely interventions to improve neonatal care and treatment outcomes.
PMID:42579702 | DOI:10.1371/journal.pone.0355843
