{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T17:41:58Z","timestamp":1792777318533,"version":"4.5.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union and Addis Ababa University","award":["ARISE-PP-FA-050"],"award-info":[{"award-number":["ARISE-PP-FA-050"]}],"id":[{"id":"https:\/\/ror.org\/038b8e254","id-type":"ROR","asserted-by":"crossref"}]},{"name":"European Union and Addis Ababa University","award":["ARISE-PP-FA-050"],"award-info":[{"award-number":["ARISE-PP-FA-050"]}],"id":[{"id":"https:\/\/ror.org\/038b8e254","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic>p<\/jats:italic>\n                      -value\u2009&lt;\u20090.05 at a 95% confidence level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2009=\u20091\u20134). Factors independently associated with unfavorable outcomes included sex (AOR\u2009=\u20092.684, 95% CI\u2009=\u20091.177\u20136.119), duration from disease onset to hospital visit (AOR\u2009=\u20091.433, 95% CI\u2009=\u20091.043\u20131.967), and history of antibiotic intake before hospital visit (AOR\u2009=\u20092.784, 95% CI\u2009=\u20091.270\u20136.104).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0361291","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T17:34:43Z","timestamp":1792776883000},"page":"e0361291","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The hidden burden of viral meningitis in ethiopia: Etiology and clinical outcomes"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7346-2202","authenticated-orcid":true,"given":"Derso Wale","family":"Mesele","sequence":"first","affiliation":[{"name":"College of Medicine and Health Science, Wolkite University","place":["Wolkite, Ethiopia"],"department":["Department of Medical Laboratory Science"]},{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lema","family":"Ayele","sequence":"additional","affiliation":[{"name":"College of Health Science, Arsi University","place":["Asella, Ethiopia"],"department":["Department of Medical Laboratory Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemal","family":"Aman","sequence":"additional","affiliation":[{"name":"College of Health Science, Madda Walabu University","place":["Robe, Ethiopia"],"department":["Department of Medical Laboratory Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawit Hailu","family":"Alemayehu","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashenafi","family":"Alemu","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aschalew","family":"Gelaw","sequence":"additional","affiliation":[{"name":"School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar","place":["Gondar, Ethiopia"],"department":["Department of Medical Microbiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5885-4119","authenticated-orcid":true,"given":"Yared","family":"Merid","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, Hawassa University","place":["Hawassa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adane","family":"Mihret","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andargachew","family":"Mulu","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getachew Tesfaye","family":"Beyene","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"issue":"2","key":"pone.0361291.ref001","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/QCO.0000000000000355","article-title":"Viral meningitis: Current issues in diagnosis and treatment","volume":"30","author":"F McGill","year":"2017","journal-title":"Curr Opin Infect Dis"},{"issue":"1","key":"pone.0361291.ref002","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12985-025-02730-w","article-title":"Viral meningitis in Sub-Saharan Africa: Trends in prevalence, etiologies, and diagnostic approaches","volume":"22","author":"A 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