Predictive signs and symptoms of Bacterial Meningitis isolates in Northern Ghana

Background Cerebrospinal meningitis (CSM) is a public health burden in Ghana that causes up to 10% mortality of the disease annually. About 20% of those who survive cerebrospinal meningitis suffer permanent sequelae. The study sought to understand the predictive signs and symptoms of bacterial meningitis implicated in its outcomes. Method Retrospective data from the Public Health Division, Ghana Health Service on bacterial meningitis from 2015 to 2019 used for this study. A pre-tested data extraction form was used to collect patients’ information from case-based forms kept at the Disease Control Unit from 2015 to 2019. Data were transcribed from the case-based forms into a pre-designed Microsoft Excel template. The data was cleaned and imported into SPSS version 26 for analysis. Results Between 2015-2019, a total of 2,446 CSM cases were reported. Out of these, 842 were confirmed. Among the confirmed cases, males constituted 55.3%. Children below 14 years of age were most affected (51.4%). The pathogens commonly responsible for bacterial meningitis were Neisseria meningitidis and Streptococcus pneumoniae with their respective strains especially Nm W135, Nm X, Spn St. 1 , and Spn St. 12F/12A/12B/44/4 being responsible for most of the confirmed cases. The most predictive sign and symptom for bacterial meningitis was fever ( X 2 =5 . 738 a ; p <0 . 05; AOR=1 . 303 ). Identified signs that were associated but less likely to cause disease were abdominal pain ( X 2 =12 . 038 a ; p <0 . 05; AOR=0 . 597) , neck stiffness ( X 2 =6 . 447 a ; p <0 . 05; AOR=0 . 788) , altered consciousness ( X 2 =15 . 438 a ; p <0 . 05; AOR=0 . 673) , and convulsion ( X 2 =15 . 084 a ; p <0 . 05; AOR=0 . 678) . Conclusion The confirmed cases of bacterial meningitis from 2015 to 2019 had fever as the main predictive symptom. It is therefore noticed that abdominal pain, neck stiffness, altered consciousness and convulsion did not associate with CSM within the study period. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study team did not receive any form of funding from any organisation, institution or company for the purposes of the research ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The manuscript was granted Ethical Clearance from the KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY ETHICS COMMITTEE BOARD (Committee on Human Research, Publications & Ethics) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Yes, all data are available and confidential under oath with the research team and availability will be on request