TY - JOUR
T1 - Global, regional, and national burden of meningitis and its aetiologies, 1990–2019
T2 - a systematic analysis for the Global Burden of Disease Study 2019
AU - GBD 2019 Meningitis and Antimicrobial Resistance Collaborators
AU - Wunrow, Han Yong
AU - Bender, Rose G.
AU - Vongpradith, Avina
AU - Sirota, Sarah Brooke
AU - Swetschinski, Lucien R.
AU - Novotney, Amanda
AU - Gray, Authia P.
AU - Ikuta, Kevin S.
AU - Sharara, Fablina
AU - Wool, Eve E.
AU - Aali, Amirali
AU - Abd-Elsalam, Sherief
AU - Abdollahi, Ashkan
AU - Abdul Aziz, Jeza Muhamad
AU - Abidi, Hassan
AU - Aboagye, Richard Gyan
AU - Abolhassani, Hassan
AU - Abu-Gharbieh, Eman
AU - Adamu, Lawan Hassan
AU - Adane, Tigist Demssew
AU - Addo, Isaac Yeboah
AU - Adegboye, Oyelola A.
AU - Adekiya, Tayo Alex
AU - Adnan, Mohammad
AU - Adnani, Qorinah Estiningtyas Sakilah
AU - Afzal, Saira
AU - Aghamiri, Shahin
AU - Aghdam, Zahra Babaei
AU - Agodi, Antonella
AU - Ahinkorah, Bright Opoku
AU - Ahmad, Aqeel
AU - Ahmad, Sajjad
AU - Ahmadzade, Mohadese
AU - Ahmed, Ali
AU - Ahmed, Ayman
AU - Ahmed, Jivan Qasim
AU - Ahmed, Meqdad Saleh
AU - Akinosoglou, Karolina
AU - Aklilu, Addis
AU - Akonde, Maxwell
AU - Alahdab, Fares
AU - Al-Ahdal, Tareq Mohammed Ali
AU - Alanezi, Fahad Mashhour
AU - Albelbeisi, Ahmed Hassan
AU - Alemayehu, Tsegaye Begashaw B.
AU - Alene, Kefyalew Addis
AU - Al-Eyadhy, Ayman
AU - Al-Gheethi, Adel Ali Saeed
AU - Ali, Abid
AU - Ali, Beriwan Abdulqadir
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2023/8
Y1 - 2023/8
N2 - Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods: We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings: In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation: Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. Funding: Bill & Melinda Gates Foundation.
AB - Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods: We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings: In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation: Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. Funding: Bill & Melinda Gates Foundation.
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U2 - 10.1016/S1474-4422(23)00195-3
DO - 10.1016/S1474-4422(23)00195-3
M3 - Article
C2 - 37479374
AN - SCOPUS:85165009783
SN - 1474-4422
VL - 22
SP - 685
EP - 711
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 8
ER -