Global Burden and Its Association with Socioeconomic Development Status of Meningitis Caused by Specific Pathogens over the Past 30 years: A Population-Based Study

Abstract

Background: Meningitis is a severe and fatal neurological disease and causes lots of disease burden. The purpose of this study was to assess the global, regional, and national burdens and trends of meningitis by age, sex, and etiology.

Methods: Data on the burden of meningitis were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. R and Joinpoint were used for statistical analysis and charting.

Results: In 2019, meningitis caused 236,222 deaths and 15,649,865 years of life lost (YLL) worldwide. The age-standardized death rate and age-standardized YLL rate of meningitis were 3.29 and 225, which decreased steadily. Burden change was mainly driven by epidemiological changes. Regionally, meningitis burden was the highest in Sub-Saharan Africa. Burden of disease increasingly concentrated in low sociodemographic index countries, and this was most pronounced in meningitis caused by N. meningitidis. Countries such as Mali, Nigeria, Sierra Leone, etc., especially need to enhance the rational allocation of public health resources to reduce the disease burden. Children and men were more likely to be affected by meningitis. PM2.5 was found to be an important risk factor.

Conclusions: This study provides the first comprehensive understanding of the global disease burden of meningitis caused by specific pathogens and highlights policy priorities to protect human health worldwide, with particular attention to vulnerable regions, susceptible populations, environmental factors, and specific pathogens.

Keywords: Global Burden of Disease; Meningitis; Pathogen; Socioeconomic status.

Fig. 1.

Trends in ASDR and ASYR for meningitis overall and for meningitis due to three etiologies, Hib, N. meningitidis, and S. pneumoniae, 1990–2019. a Meningitis; b meningitis due to Hib; c meningitis due to N. meningitidis; d meningitis due to S. pneumoniae. ASDR, age-standardized death rate; ASYR, age-standardized years of life lost rate; Hib, Haemophilus influenzae type B; N. meningitidis, Neisseria meningitidis; S. pneumoniae, Streptococcus pneumoniae; YLL, years of life lost.

Fig. 2.

Regional ASDRs of meningitis in 2019 and their ARCs from 1990 to 2019 for different sexes. a ASDR and ARC in ASDR of meningitis; b ASDR and ARC in ASDR of meningitis due to Hib; c ASDR and ARC in ASDR of meningitis due to N. meningitidis; d ASDR and ARC in ASDR of meningitis due to S. pneumoniae. ARC, annual rate of change; ASDR, age-standardized death rate; Hib, Haemophilus influenzae type B; N. meningitidis, Neisseria meningitidis; S. pneumoniae, Streptococcus pneumoniae.

Fig. 3.

Disease burden and ARC of meningitis in 204 countries and territories. a ASDR of meningitis in 2019; b ASYR of meningitis in 2019; c ARC in ASDR of meningitis between 1990 and 2019; d ARC in ASYR of meningitis between 1990 and 2019. ARC, annual rate of change; ASDR, age-standardized death rate; ASYR, age-standardized years of life lost rate; YLL, years of life lost. Note: The raw data are from GBD2019, and possible zoning issues are not our focus.

Fig. 4.

SDI-related health inequality concentration curves and regression lines for the burden of meningitis across the world, 1990 and 2019. a Health inequality concentration curve of death; b health inequality concentration curve of YLL; c health inequality regression line of ASDR; d health inequality regression line of ASYR. ASDR, age-standardized death rate; ASYR, age-standardized years of life lost rate; SDI, sociodemographic index; YLL, years of life lost.

Fig. 5.

Frontier analysis based on SDI and age-standardized meningitis rate. Frontier analysis based on SDI and age-standardized meningitis a death rate and b YLL rate from 1990 to 2019. The frontier is delineated in solid black color. Frontier analysis based on SDI and age-standardized meningitis c death rate d YLL rate in 2019. The frontier is delineated in solid black color. Countries and territories are represented as dots. The top 10 countries with the largest effective difference (largest burden gap from the frontier) are labeled in black; examples of frontier countries with low SDI (<0.5) and low effective difference are labeled in blue, and examples of countries and territories with high SDI (>0.85) and relatively high effective difference for their level of development are labeled in red. SDI, sociodemographic index; YLL, years of life lost.

Fig. 6.

Death rate and YLL rate due to meningitis and three etiologies: Hib, N. meningitidis, and S. pneumoniae for different ages from 1990 to 2019 and for different ages and sexes in 2019. a Trends of death rate and YLL rate of different age groups due to meningitis and three etiologies, 1990–2019; b death rate and YLL rate due to meningitis and three etiologies by age and sex in 2019. ASDR, age-standardized death rate; ASYR, age-standardized years of life lost rate; Hib, Haemophilus influenzae type B; N. meningitidis, Neisseria meningitidis; S. pneumoniae, Streptococcus pneumoniae; YLL, years of life lost. Note: Upper columns stand for male, and lower columns stand for female.