The hidden burden of viral meningitis in ethiopia: Etiology and clinical outcomes.

Authors

Derso Wale Mesele, Lema Ayele, Jemal Aman, Dawit Hailu Alemayehu, Ashenafi Alemu, Aschalew Gelaw, Yared Merid, Adane Mihret, Andargachew Mulu, Getachew Tesfaye Beyene

Published in

PloS one. Volume 21. Issue 10. Pages e0361291. Epub Oct 23, 2026.

Abstract

Viral meningitis remains a significant global public health problem, particularly in resource-limited settings where the diagnosis of viral etiology is mainly based on clinical assessment. This study aimed to identify the common viral etiologies of meningitis, describe their associated clinical features, and assess patient outcomes among individuals suspected of meningitis without evidence of bacterial meningitis.
We conducted a multicenter study involving 430 patients clinically suspected of meningitis. Clinical data and cerebrospinal fluid samples (CSF) were collected following standard procedures. Viral nucleic acids were extracted from CSF specimens. Complementary DNA was prepared from viral RNA using reverse transcription. Viral nucleic acids were amplified and detected using qualitative conventional polymerase chain reactions. Patient outcomes were evaluated using the Glasgow Outcome Scale (GOS). Bivariate and multivariable logistic regression analyses were used to identify factors associated with unfavorable patient outcomes, with statistical significance set at a p-value < 0.05 at a 95% confidence level.
The prevalence of viral meningitis was 52.8% (227/430). Enteroviruses were the most common, 47.9% (206/430), followed by herpes simplex virus-1, 2.8% (12/430), herpes simplex virus-2, 1.4% (6/430), and Epstein-Barr virus, 0.7% (3/430). Overall, 6.7% (29/430) of study participants experienced unfavorable outcomes (GOS = 1-4). Factors independently associated with unfavorable outcomes included sex (AOR = 2.684, 95% CI = 1.177-6.119), duration from disease onset to hospital visit (AOR = 1.433, 95% CI = 1.043-1.967), and history of antibiotic intake before hospital visit (AOR = 2.784, 95% CI = 1.270-6.104).
In this predominantly pediatric study, enteroviruses are the leading cause of viral meningitis in Ethiopia. Most study participants experienced favorable outcomes. Unfavorable outcomes were independently associated with sex, duration from disease onset to hospital visit, and history of antibiotic use before hospital visit. Further identification and characterization of Enteroviruses are warranted.

PMID:
42912798
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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