Epidemiological, Clinical, Biological and Therapeutic Profile of Bacterial Meningitis and Factors Associated with Lethality: A Retrospective Study in the Clinic Infectious and Tropical Diseases of Fann Hospital (2020-2023)

Abstract

Introduction: Bacterial meningitis remains a major public health problem in Africa, with a persistently high incidence and case fatality. The objective of this study is to describe the epidemiological, clinical, biological and therapeutic profile of bacterial meningitis, and to identify the factors associated with lethality. Patients and Methods: A descriptive and analytical retrospective study was conducted from the records of patients hospitalized for bacterial meningitis at the SMIT in Fann January 2020 and December 31, 2023. A multivariate regression analysis, with a significance threshold set at 5%, was performed using R software version 4.2.0. Results: During the study period, we collected 138 inpatient records of patients hospitalised for bacterial meningitis, representing a hospital frequency of 3.06%. The median age of patients was 35 years with IQR: [27-52].  HIV infection (17.39%), high blood pressure (8.76%) and diabetes (8.03%) were the most common comorbidities. Cerebrospinal fluid (CSF) was clear in nearly half of the cases (49.28%), and cytology found a predominantly polynuclear neutrophil white blood cell count in 50% of cases. The median length of hospital stay was 10 days with IQI [7-17]. The most commonly used antibiotic was ceftriaxone, which was administered to 92.04% of patients. During hospitalization, 49 patients died, i.e., a case fatality rate of 35.51%. Factors associated with death were HIV infection (aOR= 3.09; 95% CI [1.05-9.57]), p-value=0,041, a Glasgow score < 13 (aOR: 3.62; 95% CI [1.57-8.57]), p-value=0,03 and CRP > 96 mg/L (aOR: 2.85; 95% CI [1.25-6.72]), p-value=0,013. Conclusion: Bacterial meningitis has a high lethality rate at the Clinic of infectious and tropical diseases of Fann Hospital. Improving immunization coverage, strengthening diagnostic capacity and early management could reduce this fatality.