Determinants of mortality among pediatric patients admitted to Wolaita Sodo University Comprehensive Specialized Hospital with acute bacterial meningitis, Southern Ethiopia: an unmatched case–control study

BACKGROUND: People of all ages suffer from acute bacterial meningitis, but children are the most vulnerable, accounting for over 50% of all cases and deaths in children under the age of five. It is the leading cause of morbidity, mortality, and long-term suffering worldwide. Children are at great risk of disease and mortality due to a lack of specific immunity associated with their young age. As a result, determinants of death were found among pediatric patients treated with acute bacterial meningitis at Wolaita Sodo University Comprehensive Specialized Hospital in Southern Ethiopia. METHODS: A facility-based unmatched case–control study was conducted on pediatric patients admitted with acute bacterial meningitis at Wolaita Sodo University Comprehensive Specialized Hospital from July 1, 2019, to June 30, 2022. A total of 355 (71 cases and 284 controls) pediatric medical charts were used for data extraction using a preestablished checklist. Data were checked for completeness and consistency, entered into Epi-Data version 4.6 software, and transported to SPSS version 25 for analysis. Multivariable logistic regression analysis was performed to identify the independent determinants of acute bacterial meningitis mortality at a P value of < 0.05 along with a 95% confidence interval (CI). RESULTS: Age between 2 months and 5 years (adjusted odds ratio (AOR) = 3.19, 95% CI = 1.15–8.88), admission in the summer season (AOR = 0.27, 95% CI = 0.15–0.49), and family size greater than or equal to six (AOR = 3.13, 95% CI = 1.76–5.56), initial antibiotic change (AOR = 10.81, 95% CI = 2.10–55.7), clinical features at presentation such as loss of consciousness (AOR = 16.90, 95% CI = 4.70–60.4), abnormal body movements (seizures) (AOR = 6.51, 95% CI = 1.82–23.4), increased intracranial pressure (AOR = 3.63, 95% CI = 1.78–7.4), malnutrition (AOR = 2.98, 95% CI = 1.34–6.59) and presence of more than one comorbidity (AOR = 3.03, 95% CI = 1.03–9.03) were found to be determinants of acute bacterial meningitis mortality. CONCLUSIONS: In summary, children aged 2 months to 5 years from large families ( > = 6) with a history of initial antibiotic change, malnutrition, more than one comorbidity, and worse clinical characteristics were related to greater death due to acute bacterial mortality in this study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-023-04410-6.