Magnitude of neonatal meningitis and associated factors among newborns with neonatal sepsis admitted to the University of Gondar Comprehensive Specialized Hospital, North Gondar, Ethiopia.

Abstract

Neonatal meningitis continues to be a devastating infection with high mortality and morbidity worldwide. The prevalence of neonatal meningitis varies across countries. However, there is a paucity of studies on neonatal meningitis in most low-resource settings. Therefore, this study aimed to determine the magnitude, clinical presentations, and associated risk factors of meningitis among newborns with neonatal sepsis. An institution-based, cross-sectional study was conducted among newborns with neonatal sepsis from May 1, 2021, to Oct 30, 2021. Neonates with neonatal sepsis admitted to the University of Gondar Comprehensive Specialized Hospital (UOGCSH) during the study period were included in the study. Single population proportion formula was used to calculate the sample size and a systematic random sampling technique was used to select the study participants. Two trained pediatric residents collected the data by using a pretested, structured questionnaire. The data was entered into Epi-info version 7.0 and exported to SPSS version 24.0 for analysis. Binary logistic regression was used to identify the associated factors. P-value<0.05 was considered statistically significant. A total of 171 participants were enrolled in this study. The mean postnatal age was 10.74±8.0 days. The male to female ratio was l.3:1. The prevalence of neonatal meningitis among suspected sepsis was 19.3%; 95% CI [13.5%-25.1%]. The prevalence of meningitis was 22.8% in Early-Onset Neonatal Sepsis and 16.8% in Late-onset Neonatal Sepsis. Neurologic symptoms (seizure & altered mentation) were seen in 25% of the patients with meningitis. Two risk factors, Prolonged labor (adjusted odds ratio [AOR]: 4.98; 95% CI: 1.99-12.48) and Prolonged Rupture of Membrane (AOR: 5:38; 95% CI: 1.92-14.42) were significantly associated with neonatal meningitis. The prevalence of neonatal meningitis was higher in early-onset neonatal sepsis than in late-onset neonatal sepsis. Obstetric factors were associated with neonatal meningitis. We recommend that routine CSF analysis should be practiced in all neonates with neonatal sepsis regardless of their postnatal age and clinical features. Early detection and treatment of obstetric factors may have the potential to reduce neonatal meningitis.