Published in PLOS One on 2026-08-11, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Getahun Tamiru Yirsaw, Tadesse Bekele Tafesse, Abera Jambo Bune, Shambel Nigussie Amare, Dominic Umoru
Source: PLOS One • DOI 10.1371/journal.pone.0355843
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Meningitis in neonates remains a major public health concern, particularly in low- and middle-income countries. Despite its high morbidity and mortality, evidence on treatment outcomes and determinants of poor prognosis is limited. This study aimed to assess treatment outcomes of meningitis and its associated factors among neonates admitted to public hospitals in Harar town, Ethiopia.
A facility-based cross-sectional study was conducted among 506 neonates diagnosed with meningitis admitted between October 2020 and October 2024. Data were extracted from medical records. Treatment outcomes were categorized as good or poor. Binary and multivariable logistic regression analyses were performed to identify factors associated with poor treatment outcomes. Statistical significance was declared at a p-value <0.05 using adjusted odds ratios (AORs) with 95% confidence intervals (CIs).
A total of 169 (33%) neonates experienced poor treatment outcomes. Assisted vaginal delivery (AOR = 3.70; 95% CI: 1.42–9.69), positive cerebrospinal fluid (CSF) culture (AOR = 3.74; 95% CI: 1.76–7.96), elevated CSF white blood cell count >2500 cells/mm³ (AOR = 6.10; 95% CI: 2.54–14.69), high CSF protein >400 mg/dL (AOR = 5.43; 95% CI: 2.84–10.36), low CSF glucose <10 mg/dL (AOR = 3.57; 95% CI: 1.64–7.80), seizures at admission (AOR = 5.07; 95% CI: 2.71–9.46), seizures after admission (AOR = 3.88; 95% CI: 1.82–8.25), early-onset neonatal sepsis (AOR = 4.27; 95% CI: 2.03–8.99), and non-exclusive breastfeeding (AOR = 2.20; 95% CI: 1.06–4.57) were predictor of poor treatment outcomes.
About one-third of neonates with meningitis experienced poor treatment outcomes. Factors associated with poor outcomes included assisted vaginal delivery, severe CSF abnormalities (positive culture, high white blood cell count, elevated protein, and low glucose), seizures at or after admission, early-onset neonatal sepsis, and non-exclusive breastfeeding. These findings highlight the need for early risk stratification and timely interventions to improve neonatal care and treatment outcomes.
Introduction
Meningitis is a serious infection that causes inflammation of the subarachnoid space of the brain and spinal cord. It is usually caused by bacteria, viruses, fungi, or parasites [1]. Newborns are especially vulnerable due to immature immunity, with neonatal meningitis classified as early-onset (≤72 hours after birth) or late-onset (>72 hours) [2,3].
The pathogens causing neonatal meningitis depend on gestational age, postnatal age, and location [3]. Early-onset cases are mainly due to Group B Streptococcus (GBS) and Escherichia coli (E. coli) [2,4–7]. Late-onset pathogens vary by gestational age, birth weight, and healthcare setting: GBS and E. coli are common in community-acquired cases, while staphylococci, Staphylococcus aureus (S. aureus), and Klebsiella species are frequent in healthcare-associated infections [7–10].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Getahun Tamiru Yirsaw, Tadesse Bekele Tafesse, Abera Jambo Bune, Shambel Nigussie Amare, Dominic Umoru. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Early mortality risk stratification in childhood bacterial meningitis using cerebrospinal fluid glucose and protein levels and their combinations: A multicontinental cohort study
- Evidence brief: Bacteriological profiles, antimicrobial resistance patterns, and predictors of culture-confirmed neonatal Sepsis at Asella Teaching Hospital, Southeast Ethiopia
- Evidence brief: Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025
