{ "abstract": "Background: 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. Methods: 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. Results: 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). Conclusions: 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.", "abstract_shown": true, "affiliations": [ "Department of Medical Laboratory Science, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.", "Armauer Hansen Research Institute, Addis Ababa, Ethiopia.", "Department of Medical Laboratory Science, College of Health Science, Arsi University, Asella, Ethiopia.", "Department of Medical Laboratory Science, College of Health Science, Madda Walabu University, Robe, Ethiopia.", "Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.", "College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia." ], "article_type": "Research Article", "arxiv": null, "author_total": 10, "authors": [ { "affs": [ 0, 1 ], "name": "Derso Wale Mesele", "orcid": "0009-0008-7346-2202" }, { "affs": [ 2 ], "name": "Lema Ayele" }, { "affs": [ 3 ], "name": "Jemal Aman" }, { "affs": [ 1 ], "name": "Dawit Hailu Alemayehu" }, { "affs": [ 1 ], "name": "Ashenafi Alemu" }, { "affs": [ 4 ], "name": "Aschalew Gelaw" }, { "affs": [ 5 ], "name": "Yared Merid", "orcid": "0000-0002-5885-4119" }, { "affs": [ 1 ], "name": "Adane Mihret" }, { "affs": [ 1 ], "name": "Andargachew Mulu" }, { "affs": [ 1 ], "name": "Getachew Tesfaye Beyene" } ], "bibtex": "https://research.draconitic.com/paper/57pe0sjv80qte.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0361291", "fulltext_url": "https://europepmc.org/articles/PMC13693901", "id": "57pe0sjv80qte", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0361291", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2725|Infectious Encephalopathies and Encephalitis" ], [ "plos", "/Biology and life sciences/Microbiology/Microbial control/Antimicrobials/Antibiotics" ], [ "plos", "/Biology and life sciences/Microbiology/Virology/Viral replication/Viral nucleic acid" ], [ "plos", "/Biology and life sciences/Molecular biology/Molecular biology techniques/Artificial gene amplification and extension/Polymerase chain reaction" ], [ "plos", "/Medicine and health sciences/Medical conditions/Infectious diseases/Bacterial diseases/Bacterial meningitis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Infectious diseases/Infectious diseases of the nervous system/Meningitis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Infectious diseases/Infectious diseases of the nervous system/Meningitis/Bacterial meningitis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Inflammatory diseases/Meningitis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Inflammatory diseases/Meningitis/Bacterial meningitis" ], [ "plos", "/Medicine and health sciences/Neurology/Infectious diseases of the nervous system/Meningitis" ], [ "plos", "/Medicine and health sciences/Neurology/Infectious diseases of the nervous system/Meningitis/Bacterial meningitis" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Etiology" ], [ "plos", "/Medicine and health sciences/Pharmacology/Drugs/Antimicrobials/Antibiotics" ], [ "plos", "/People and places/Geographical locations/Africa/Ethiopia" ], [ "plos", "/Physical sciences/Materials science/Material properties/Mechanical properties/Stiffness" ], [ "plos", "/Research and analysis methods/Molecular biology techniques/Artificial gene amplification and extension/Polymerase chain reaction" ] ], "openalex": "W7223287138", "pdf_url": "https://europepmc.org/articles/PMC13693901?pdf=render", "pmcid": "PMC13693901", "pmid": "42912798", "published": "2026-10-23", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/57pe0sjv80qte.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pone.0361291", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0361291" }, { "first_seen": "2026-10-30T12:20:03Z", "native_id": "MED:42912798", "source": "europepmc", "url": "https://europepmc.org/article/MED/42912798" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:infectious diseases", "subfield": "infectious-disease" }, { "field": "medicine", "origin": "plos:neurology", "subfield": "neurology" } ], "title": "The hidden burden of viral meningitis in ethiopia: Etiology and clinical outcomes", "title_text": "The hidden burden of viral meningitis in ethiopia: Etiology and clinical outcomes", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:03Z", "url": "https://research.draconitic.com/paper/57pe0sjv80qte", "venue": "PLOS One", "versions": [] }