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. 2025 Apr 15;22(1):100.
doi: 10.1186/s12985-025-02730-w.

Viral meningitis in Sub-Saharan Africa: trends in prevalence, etiologies, and diagnostic approaches

Alene Geteneh  1 , Mulugeta Kiros  2 , Ephrem Tamrat  3 , Aragaw Tesfaye  4 , Yalewayker Gashaw  3 , Sirak Biset  5 , Melese Abate Reta  3
Affiliations

Viral meningitis in Sub-Saharan Africa: trends in prevalence, etiologies, and diagnostic approaches

Alene Geteneh et al. Virol J. .

Abstract
in English, French, German

Viral meningitis is a significant yet often underreported public health concern in Sub-Saharan Africa (SSA), where diagnostic limitations and surveillance gaps hinder accurate case detection. This systematic review examines epidemiological trends, etiologies, and laboratory diagnostic approaches to viral meningitis across SSA from 1987 to 2024. This data reveal that the prevalence of viral meningitis has shown an overall increasing trend, with a considerable year-to-year variability influenced by seasonal outbreaks, improved diagnostic methods, and enhanced surveillance efforts. Human enteroviruses (HEVs) were the most frequently identified causative agents, accounting for 1,164 confirmed cases, followed by the herpesvirus family, including Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Other detected viral pathogens include mumps virus, adenoviruses, coxsackievirus, and arboviruses such as dengue virus. The shift from traditional viral cultures to polymerase chain reaction (PCR) and multiplex PCR has significantly improved the case detection. Despite these advancements, substantial gaps remain in diagnostic accessibility, surveillance systems, and less research focus on viral meningitis in SSA. Addressing these challenges through improved surveillance, enhanced diagnostic capacity, and targeted public health strategies is crucial for mitigating the burden of viral meningitis in the region.

Viral meningitis is a significant yet underreported public health issue in Sub-Saharan Africa (SSA), where diagnostic limitations and surveillance gaps hinder accurate case detection. Thus, this systematic review examines the epidemiological trends, etiologies, and diagnostic approaches for viral meningitis in SSA from 1987 to 2024, aiming to highlight the prevalence, causative agents, and advancements in laboratory diagnostics.

• The prevalence of viral meningitis in SSA has shown an increasing trend, driven by improved diagnostic methods and seasonal outbreaks. • Human enteroviruses (HEVs) are the predominant causative agents, followed by herpesviruses (EBV, CMV) and mumps virus. • The shift from traditional viral cultures to PCR and multiplex PCR has significantly improved case detection, though diagnostic accessibility remains limited in many regions. • There is a critical need for enhanced surveillance, diagnostic capacity, and public health strategies to address the burden of viral meningitis in SSA.

Keywords: Diagnostic methods; Enteroviruses; Epidemiology; Sub-Saharan Africa; Viral meningitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Country-specific distribution of viral meningitis cases in SSA
Fig. 2
Fig. 2
Trend of viral meningitis by years of publications, 1987–2024
See this image and copyright information in PMC

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