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. 2024 Nov 30;16(11):e74827.
doi: 10.7759/cureus.74827. eCollection 2024 Nov.

Factors Associated With Mortality Among Hospitalized Children With Acute Bacterial Meningitis in a Resource-Limited Setting: A Retrospective Study

Nabil Aljuma'ai  1 , Faisal Ahmed  2 , Mohammed Almogahed  3 , Hanan Al-Barahi  4 , Abdulghani Al-Hagri  5 , Ola Alnadhary  6 , Abdulghani A Ghabisha  3
Affiliations

Factors Associated With Mortality Among Hospitalized Children With Acute Bacterial Meningitis in a Resource-Limited Setting: A Retrospective Study

Nabil Aljuma'ai et al. Cureus. .

Abstract

Background: Acute bacterial meningitis (ABM) is a significant public health problem in developing countries, including Yemen, especially during warfare. This is because persistent political turmoil impedes ABM prevalence, etiology, and treatment. Here, we investigate the factors associated with mortality among hospitalized children with ABM in a resource-limited setting.

Material and method: A retrospective study between March 2018 and December 2023 at the Pediatric Center, Althora General Hospital, Yemen, included 387 children (aged <15 years) diagnosed with ABM and confirmed by bacteriology. The data on patient characteristics and cerebrospinal fluid (CSF) characteristics, culture, and treatment outcome were collected from the patient medical profile and analyzed. Factors associated with mortality were investigated in univariate and multivariate analysis using odds ratio (OR) and 95% confidence interval (CI).

Result: The median age was 1.00 years (interquartile range (IQR): 1.00, 4.00), with most being under one year old (n=213, 55.0%), male (n=237, 61.2%), and from rural areas (n=218, 56.3%), with symptoms lasting over five days in 58 (15%) of cases. Streptococcus pneumonia was the most common CSF culture result (n=383, 99%), with mortality reported in 15 (3.9%) cases. In multivariate analysis, younger age (OR: 1.77; 95% CI: 1.18-2.94, p=0.010), malnutrition (OR: 480.82; 95% CI: 27.78-56020.49, p=0.001), altered mental status (OR: 1536.83; 95% CI: 42.82-658,144.96, p=0.002), and the longer time before hospitalization > five days (OR: 161.84; 95 % CI: 9.97-16,700.53, p=0.005) were associated with mortality.

Conclusion: Our findings highlight the prognostic significance of early detection of a predisposing focus to ABM. Poor prognosis and mortality may be associated with younger age, delayed hospitalization, malnutrition, and altered mental status.

Keywords: acute bacterial meningitis; children; ibb; mortality; resource-limited setting; yemen.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ibb University Institutional Ethics Committee issued approval IBBUNI.AC.YEM. 2023.104. 82. The study was conducted following the Declaration of Helsinki and approved by the Ibb University Institutional Ethics Committee on 2023-06-13. Due to the anonymous retrospective nature of the study, written informed consent from the included patients was not required. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Kaplan-Meier curves for the overall mortality associated with acute bacterial meningitis.
See this image and copyright information in PMC

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