Assessment of adherence to guidelines for the management of acute bacterial meningitis in children admitted to kenyatta national hospital

Abstract

Background: acute bacterial meningitis (abm) is a disease which if not adequately and promptly managed, can lead to serious adverse effects. Evidence based guidelines in the form of ministry of health basic paediatric protocols are available which help in the proper management of the disease. It is important to follow such guidelines in order to improve outcomes. Objectives: this study was aimed at evaluating the quality of care given to children aged 2 months to 5yrs with abm, to determine the proportion which gets proper treatment. The study also aimed to find out the outcomes of children who were managed for abm at kenyatta national hospital (knh). Methodology: the study was a cross-sectional study, involving children aged 2months to 5years, who were admitted to knh general paediatric wards between december 2018 and january 2019. The children with suspected acute bacterial meningitis based on the case definition in the guidelines on admission, were identified on discharge and information on the care given to them during the period of admission was extracted from their files using a structured data form. Data analysis: the data collected was entered into spss and analysis was done using spss version 23.0. Results were then presented in the form of means and proportions for demographic data and clinical characteristics, as proportions for correct assessment, management and outcomes. Results and conclusions: out of 276 patients with suspected abm, the proportion that was correctly managed was 32.2%. Only 35.9% had a lumber puncture done and 42.8% of the patients received the recommended antibiotics on admission. The proportion of patients who died while receiving treatment was 14.1% and the mean length of hospital stay was 11days. Recommendations: it was recommended that use of evidence-based guidelines (ebg) in management of patients with abm should be enforced to health workers in order to improve outcomes.