Treatment Outcomes of Meningitis and Its Associated Factors among Neonates Admitted in Public Hospitals at Harar Town, Ethiopia: Cross-sectional study

Aim & 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 (CSF) (AOR = 3.53, 95% CI: 1.45 to 8.57), CSF protein more than 400 mg/dl at admission (AOR = 17.9, 95% CI: 7.95 to 40.3), CSF 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 CSF culture, seizures, elevated CSF protein with low glucose, and co-occurrence with early-onset neonatal sepsis. Clinical Significance: This study is important for enhancing patient care by reducing mortality and morbidity. Recognizing the factors that influence outcomes allows for targeted measures, early detection of at-risk newborns, and more effective treatment strategies.