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2016年埃塞俄比亚转诊医院儿童脑膜炎的临床结局及危险因素:一项回顾性病历审查

Clinical Outcomes and Risk Factors of Meningitis among Children in Referral Hospital, Ethiopia, 2016: A Retrospective Chart Review.

作者信息

Tewabe Tilahun, Fenta Amare, Tegen Abaynesh, Mezgebu Muluwork, Fentie Temesgen, Zeleke Tigist

机构信息

College of medicine and Health Sciences, Bahir Dar university, Ethiopia.

出版信息

Ethiop J Health Sci. 2018 Sep;28(5):563-570. doi: 10.4314/ejhs.v28i5.7.

Abstract

BACKGROUND

Meningitis remains a major cause of mortality and morbidity in patients in many countries of the world including Ethiopia. Information on clinical outcomes of meningitis, susceptibility of the causative microorganism to rationalize treatment and associated risk factors is scare. The objective of this study was to assess the risk factors and clinical outcomes of meningitis among children in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia.

METHOD

A retrospective cross sectional study was conducted in Felege Hiwot Referral Hospital from January 2016 to May 2016. Data were checked for completeness, inconsistencies and entered into SPSS for windows version 20.0. Lottery method was used to select charts. One hundred seventy-nine pediatric patient files were used in the study.

RESULT

About 15% children with meningitis developed poor outcomes: developed complication, referred to higher facility, died and left against medical advice. In this study, season of admission [AOR= 5 (1.191, 20.991)], immunization status [AOR= 20.912 (3.325, 131.502)], clinical presentations [AOR= 8.779 (1.599, 48.192)] and corticosteroid administration [AOR= 8.215 (1.220, 55.328)] were the determinant factors for clinical outcome of meningitis.

CONCLUSION

In this study, about 15% of children with meningitis developed poor outcomes. The determinant factors for poor outcome of meningitis were: season of admission, immunization status, clinical presentations and corticoid administration. Creating community awareness about risk factors of meningitis, early diagnosis and treatment of cases, improving vaccination coverage and use of corticosteroids are recommended to improve the clinical outcome of children affected with meningitis.

摘要

背景

在包括埃塞俄比亚在内的世界许多国家,脑膜炎仍然是患者死亡和发病的主要原因。关于脑膜炎临床结局、致病微生物药敏以合理治疗以及相关危险因素的信息匮乏。本研究的目的是评估埃塞俄比亚西北部巴赫达尔市费莱格·希沃特转诊医院儿童脑膜炎的危险因素和临床结局。

方法

于2016年1月至2016年5月在费莱格·希沃特转诊医院进行了一项回顾性横断面研究。检查数据的完整性、一致性,并录入Windows版SPSS 20.0。采用抽签法选择病历。本研究使用了179份儿科患者档案。

结果

约15%的脑膜炎患儿预后不良:出现并发症、转诊至上级医疗机构、死亡或自动出院。在本研究中,入院季节[AOR=5(1.191,20.991)]、免疫状态[AOR=20.912(3.325,131.502)]、临床表现[AOR=8.779(1.599,48.192)]和皮质类固醇使用情况[AOR=8.215(1.220,55.328)]是脑膜炎临床结局的决定因素。

结论

在本研究中,约15%的脑膜炎患儿预后不良。脑膜炎预后不良的决定因素为:入院季节、免疫状态、临床表现和皮质类固醇使用。建议提高社区对脑膜炎危险因素的认识、对病例进行早期诊断和治疗、提高疫苗接种覆盖率以及使用皮质类固醇,以改善患脑膜炎儿童的临床结局。

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