Treatment outcome and associated factors of bacterial meningitis at pediatric wards of southwestern Ethiopian hospital: a prospective observational study

Abstract Background Meningitis is a common infectious cause of morbidity and mortality in pediatric age-groups. Acute bacterial meningitis is considered a medical emergency, because it is a life-threatening infection that requires immediate treatment. Therefore the study was aimed to assess the magnitude and predictors of poor treatment outcome among pediatric patients admitted to Bedele General Hospital. Methods A prospective observational study was conducted at pediatric wards of Bedele General Hospital from February 12, 2020 to August 11, 2020. Lumbar puncture, in the absence of contraindications, was performed under aseptic conditions for all patients with suspected bacterial meningitis to collect cerebrospinal fluid specimen. Multivariable logistic regression was used to determine the predictors of poor treatment outcome. Result Of the 196 pediatric patients involved, 112(57.1%) were male and the mean and standard deviation of their age was 6.09 ± 4.46. Regarding to their clinical profile, a total of 101(51.5%) were completely immunized and 115(58.7%) were given corticosteroid during their treatment. In our study the most frequently occurred clinical manifestation of meningitis was fever 164(83.67%), neck rigidity149 (76.02%), and irritability 122(62.24%). Regarding to their pharmacotherapy, the most commonly prescribed antibiotics were Ampicillin 104(24.82%), and Gentamycin 102(24.34%). The magnitude of good treatment outcome was 132(67.35%) whereas 64(32.65%) were poorly controlled. The presence of comorbidity (AOR = 3.64, 95CI%:1.83–7.23,P = < 0.001),corticosteroid use (AOR = 2.37, 95CI%:1.17–4.81,P = 0.017) and oxygen administration (AOR = 3.12, 95CI%: 1.34–7.25, P = 0.008) was a predictor of meningitis treatment outcome. Conclusion The treatment outcome of meningitis was good in of two-third of the patients. It was found that the presence of comorbidity, the administration of oxygen and use of corticosteroid was predictors of the treatment outcomes of bacterial meningitis in children. Therefore, in patients with these factors, appropriate meningitis treatment should be encouraged and locally applicable treatment guidelines should be prepared to improve patient outcome. Finally, the meningitis patients should be given corticosteroid and oxygen as treatment and special attention should be given for patients having co-morbidities.

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Predictors of Treatment Outcomes among Pediatric Patients Hospitalized with Pneumonia in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Advances in Pharmacological and Pharmaceutical Sciences ◽

10.1155/2021/6690622 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Hilina Tsegaw ◽

Mohammed Yimam ◽

Dejen Nureye ◽

Workineh Woldeselassie ◽

Solomon Hambisa

Keyword(s):

Treatment Outcome ◽

Sample Size ◽

Treatment Outcomes ◽

Pediatric Patients ◽

Addis Ababa ◽

Good Treatment Outcome ◽

Specialized Hospital ◽

Tikur Anbessa Specialized Hospital ◽

Poor Treatment ◽

Poor Treatment Outcome

Background. Pneumonia remains the leading cause of hospitalization and mortality in young children in low- and middle-income countries. This study is aimed to assess predictors of treatment outcomes among pediatric patients hospitalized with pneumonia in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A facility-based retrospective cross-sectional study was conducted among pediatric patients admitted with pneumonia, considering patient medical charts recorded for a 1-year period from February 2017 to February 2018. The sample size was computed based on a single population proportion formula and giving a total sample size of 207. The systematic random sampling method was employed to select patient cards from the sampling frame. The data extraction format was used to extract any relevant information from patient chart. The processed data were analyzed by using Statistical Package for Social Sciences (SPSS, version 21). Descriptive statistics were used to summarize the patients’ baseline characteristics and related information. The logistic regression model was fitted to determine factors associated with treatment outcomes. To identify predictors of poor treatment outcome, the level of significance was set at P < 0.05 . Results. From a total of 207 patient charts reviewed, more than half (55.6%) of the study participants were males. Majority of patients, 130 (62.8%), were in the age range of 1 month–11 months. Furthermore, 191 (92.3%) patients had good treatment outcome. Patients who treated with ceftriaxone + azithromycin were less likely to have poor treatment outcome compared with patients who were placed on crystalline penicillin (AOR = 0.86, 95% CI 0.01–0.83). On the contrary, patients who stayed ≥ 8 days were about 14.3 times more likely to have poor treatment outcome compared with patients who stayed ≤ 3 days (AOR = 14.3, 95% CI 1.35–151.1). Conclusion. Even though the study revealed good treatment outcome among the pediatric patients, particular consideration should be given to children in need of other interventions.

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Management practice, and treatment outcome and its associated factors among hospitalized stroke patient at Ambo University Referral Hospital, Ethiopia: an Institutional Based Cross Sectional Study

10.21203/rs.2.15426/v1 ◽

2019 ◽

Author(s):

Belayneh Kefale ◽

Guye Betero ◽

Gobezie Temesgen ◽

Amsalu Degu

Keyword(s):

Treatment Outcome ◽

Associated Factors ◽

Management Practice ◽

Cross Sectional Study ◽

Stroke Patients ◽

Cross Sectional ◽

Good Treatment Outcome ◽

Poor Treatment ◽

Poor Treatment Outcome ◽

Study Participants

Abstract Background: Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past few years in Ethiopia, there is a paucity of data regarding to stroke treatment outcomes and associated factors. Hence, this study was aimed to assess management practice, and treatment outcome and its associated factors among hospitalized stroke patients.Method an institutional based cross sectional study was conducted among 111 hospitalized stroke patients in the medical ward of Ambo University Referral Hospital(AURH), who had been hospitalized for the last three years (March 30/2016- May30/2019). All patients diagnosed with stroke and hospitalized in the medical ward of AURH were included in the study. Data were analyzed with SPSS version 25.0 statistical software. Bivariate and multivariate binary logistic regression analysis was conducted to identify the predictors of poor treatment outcome.Result The present study showed that ischemic stroke was the most prevalent (80.1%) form of stroke diagnosed in the study setting. Nonetheless, 18.2% of patients were diagnosed with hemorrhagic stroke. Among 111 study participants, 69 (62.2%) patients had good treatment outcome. From 42(37.8%) study participants with poor treatment outcome, 18(42.8%) were dead and 12 (28.6%) were with disability and left against medical advice on self and family request while the remaining 12 (28.6%) were referred to other higher health facility. Social history (substance abuse P=00.046, AOR=2.684, 95%CI 1.091-6.604), age (P=0.026, AOR= 3.256, 95%CI = 1.145-9.260) and chief compliant (P=0.009, AOR=0.254, 95%CI=0.091-0.708) were the predictors of treatment outcome among hospitalized stroke patients. Other variables like types of stroke, co-morbidity, and others did not show significant association with treatment outcome.Conclusion The present study showed that ischemic stroke was the most predominantly diagnosed type of stroke in our setting. Acetyl salicylic acid and ACE inhibitor based regimens were frequently used in the management of stroke and hypertension, respectively. Nearly one third of the study participants had good treatment outcome. Nonetheless, death was reported in 16.2% of hospitalized stroke patients in the study setting. Being older and substance abusers, and the presence of hemiparesis during the initial hospital admission were significant predictors of poor treatment outcome.

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Diabetic Ketoacidosis Management and Treatment Outcome at Medical Ward of Shashemene Referral Hospital, Ethiopia: A Retrospective Study

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.1177/11795514211004957 ◽

2021 ◽

Vol 14 ◽

pp. 117955142110049

Author(s):

Getu Melesie Taye ◽

Amente Jorise Bacha ◽

Fetene Abeje Taye ◽

Mohammed Hussen Bule ◽

Gosaye Mekonen Tefera

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Treatment Outcome ◽

Hospital Mortality ◽

Medical Ward ◽

Inclusion Criteria ◽

Potassium Supplementation ◽

Poor Treatment ◽

Poor Treatment Outcome ◽

Concurrent Medication

Background: Diabetic Ketoacidosis (DKA) is the most common and yet potentially life-threatening acute complication of diabetes that progresses rapidly to death and requires immediate medical intervention. Objective: To assess the DKA management and treatment outcome/in-hospital mortality and its predictors among hospitalized patients with DKA at the Medical ward of Shashemene Referral Hospital (SRH). Method: A retrospective study was conducted at the Medical Ward of SRH from 01 February 2015 to 31 January 2017. A systematic random sampling technique was used to select study subjects based on the inclusion criteria. Thus, of 236 reviewed charts, only 225 patients with DKA fulfilled inclusion criteria. Treatment outcome was considered good for patients who have shown improvement at discharge, while poor for patients who left against medical advice or died in the hospital. Logistic regression analysis was done to determine independent predictors for treatment outcome/in-hospital mortality using SPSS version 20 with statistical significant at P ⩽ .05. Results: Of 225 patients with DKA, 124 (55.1%) were male. Regular insulin was prescribed to all patients and antibiotics were administered to 87 (38.7%). Potassium supplementation was given only for 28 (12.4%). Non-adherence to insulin treatment (n = 91; 40.4%) and infection (n = 66; 29.3%) were the principal DKA precipitating factors. Even though 73.8% of hospitalized patients with DKA have shown good treatment outcomes, DKA contributed 12% in-hospital mortality. The result of multivariate logistic regression analysis shown that hypoglycemia is the only independent predictor for in-hospital mortality[ P = .03]. Moreover, the independent predictors for poor DKA treatment outcome were found to be smoker [ P = .04], Urinary tract infection (UTI) relative to other co-morbid condition [ P < .001], severe hypokalemia which increase risk of poor treatment outcome by around 4 times [ P = .02], and use of Metronidazole as a concurrent medication relative to other concurrent medication [ P = .03]. Conclusion: There was a high in-hospital mortality rate due to correctable causes. This mortality is unacceptable as it was majorly related to the poor practice of potassium supplementation and hypoglycemia due to insulin. Thus, clinicians and stakeholders should have to focus on modifiable factors (hypokalemia, UTI, and hypoglycemia) to reduce poor treatment outcome/in-hospital mortality.

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Clinical Features of Bacterial Meningitis in Italy: a Multicenter Prospective Observational Study

Journal of Chemotherapy ◽

10.1179/joc.2008.20.4.478 ◽

2008 ◽

Vol 20 (4) ◽

pp. 478-487 ◽

Cited By ~ 5

Author(s):

L. Lazzarini ◽

M. Toti ◽

P. Fabris ◽

E. Conti ◽

G. Magni ◽

...

Keyword(s):

Bacterial Meningitis ◽

Observational Study ◽

Clinical Features ◽

Prospective Observational Study ◽

Multicenter Prospective Observational Study

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619 ACTIVATED FIBROBLAST GROWTH FACTOR-INDUCIBLE 14 (FN14) PROMOTES INVASION, MIGRATION AND PROLIFERATION OF ANDROGEN INDEPENDENT PROSTATE CANCER CELLS THROUGH MATRIX METALLOPROTEINASE 9 AND CORRELATES WITH POOR TREATMENT OUTCOME

European Urology Supplements ◽

10.1016/s1569-9056(11)60608-8 ◽

2011 ◽

Vol 10 (2) ◽

pp. 201

Author(s):

S. Narita ◽

M. Mingguo ◽

N. Tsuchiya ◽

K. Numakura ◽

T. Obara ◽

...

Keyword(s):

Prostate Cancer ◽

Treatment Outcome ◽

Growth Factor ◽

Matrix Metalloproteinase ◽

Fibroblast Growth ◽

Prostate Cancer Cells ◽

Poor Treatment ◽

Poor Treatment Outcome ◽

Metalloproteinase 9 ◽

Androgen Independent

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Childhood Tuberculosis Treatment Outcome and Its Association with HIV-Co infection in Ethiopia, A Systematic Review and Meta-analysis

10.21203/rs.2.14156/v1 ◽

2019 ◽

Author(s):

Getaneh Mulualem Belay ◽

Chalachew Adugna Wubneh

Keyword(s):

Systematic Review ◽

Treatment Outcome ◽

Successful Treatment ◽

Meta Analysis ◽

Tuberculosis Treatment ◽

World Health ◽

Successful Treatment Outcome ◽

Poor Treatment ◽

Poor Treatment Outcome ◽

Tuberculosis Treatment Outcome

Abstract Introduction Globally around one million children are infected with Tuberculosis. Childhood Tuberculosis is underestimated due diagnosis challenge. HIV infection can affect the TB disease progression and treatment outcome.Objectives The aim of this systematic review and meta-analysis is to determine the pooled estimates of childhood tuberculosis treatment outcome and to analyze the impact of HIV-co infection.Methods We searched all available articles using PubMed, Google scholar and a web of science. Additionally, reference lists of included studies and Ethiopian institutional research repositories were used. Searching was limited to studies conducted in Ethiopia and published in English language. Cohort, cross-sectional and case-control studies were included. A weighted inverse variance random effects- model was used. The overall variations between studies were checked by heterogeneity test Higgins’s method (I 2 ). All included studies were assessed with the JBI quality appraisal criteria. Publication bias was checked with the funnel plot and Egger’s regression test.Result A total of 6 studies with 5,389 participants were included in this systematic review and meta-analysis. The overall pooled estimate of successful treatment outcome was found to be 79.54% (95% CI: 73.00, 86.07). Of which 72.44% were treatment completed. Moreover, this study revealed that the treatment failure, defaulter and death were 0.15%, 5.36%, and 3.54%, respectively. Poor treatment outcome was higher among children with HIV co infection with an odds ratio of 3.15 (95% CI: 1.67, 5.94) as compared to HIV negative children.Conclusion The rate of successful treatment outcome of childhood tuberculosis in Ethiopia found to be low compared to the threshold suggested by the world health organization. HIV co infection is significantly associated with poor treatment outcome. Therefore, special attention better to be given for children infected with HIV.

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