TY - JOUR
T1 - Global, regional, and national burden of meningitis, its risk factors, and aetiologies, 1990–2023
T2 - a systematic analysis for the Global Burden of Disease Study 2023
AU - GBD 2023 Meningitis & Antimicrobial Resistance Collaborators
AU - Sirota, Sarah Brooke
AU - Bender, Rose Grace
AU - Dominguez, Regina Mae Villanueva
AU - Vongpradith, Avina
AU - Movo, Amanda
AU - Swetschinski, Lucien R.
AU - Araki, Daniel T.
AU - Han, Chieh
AU - Wool, Eve E.
AU - A.J. Jabbar, Ahmed
AU - Aalipour, Mohammad Amin
AU - Aalruz, Hasan
AU - Abbasi, Madineh
AU - Abbasifard, Mitra
AU - Abbaspour, Faezeh
AU - Abbastabar, Hedayat
AU - Abd ElHafeez, Samar
AU - Abdalla, Mohammed Altigani
AU - Abdallah, Emad M.
AU - Abdel Razeq, Nadin M.I.
AU - Abd-Elsalam, Sherief
AU - Abdelwahab, Omar Ahmed
AU - Abdoun, Meriem
AU - Abdous, Arman
AU - Abdrabou, Mostafa M.
AU - Abdul Aziz, Jeza Muhamad
AU - Abdulkader, Rizwan Suliankatchi
AU - Abdullahi, Auwal
AU - Abdulmalik, Abisola Esther
AU - Abdulrahman, Rezheen Fatah
AU - Abdul-Rahman, Toufik
AU - Abedi, Armita
AU - Abejew, Asrat Agalu
AU - Abidi, Syed Hani
AU - Abil, Olifan Zewdie
AU - Abiodun, Olumide
AU - Abo Kasem, Rahim
AU - Aboagye, Richard Gyan
AU - Abolhassani, Hassan
AU - Aborode, Abdullahi Tunde
AU - Abourashed, Nagah M.
AU - Abtahi, Dariush
AU - Abu, Zhanar
AU - Abu Farha, Rana Kamal
AU - Abu Rumeileh, Samir
AU - Abuadas, Fuad Hamdi A.
AU - Abubakar, Aminu Kende
AU - Abubakar, Ibrahim Banaru
AU - Alanezi, Fahad Mashhour
AU - Alanzi, Turki M.
N1 - Publisher Copyright:
© 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
PY - 2026
Y1 - 2026
N2 - Background: Meningitis remains the leading infectious cause of neurological disabilities globally, disproportionately affecting children younger than 5 years and populations in the African meningitis belt. Whereas previous global estimates focused on ten pathogen categories, this study presents the most comprehensive analysis to date, assessing the meningitis burden attributable to 17 causative pathogens based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework. Methods: GBD is a systematic, scientific effort aimed at quantifying the comparative magnitude of health loss caused by diseases, injuries, and risk factors across age groups, sexes, and geographical locations over time. We estimated meningitis mortality using the Cause of Death Ensemble model (CODEm) and morbidity using DisMod-MR 2.1, incorporating data from vital registration, verbal autopsy, surveillance, hospital data, and systematic reviews. Aetiology-specific estimates were generated with pathogen-linked case-fatality ratios and splined binomial regression models. Risk factor attribution was based on established risk–outcome pairs and population attributable fractions. Findings: In 2023, there were 259 000 (95% uncertainty interval 202 000–335 000) global deaths and 2·54 million (2·20–2·93) incident cases of meningitis. Children younger than 5 years accounted for more than a third of deaths (86 600 [53 300–149 000]). Streptococcus pneumoniae, Neisseria meningitidis, non-polio enteroviruses, and other viruses were the leading causes of death, while non-polio enteroviruses caused the most cases. The four WHO-defined preventable meningitis pathogens of interest (S pneumoniae, N meningitidis, Haemophilus influenzae, and Group B streptococcus) contributed to 98 700 deaths (77 000–127 000) and 594 000 cases (514 000–686 000). Low birthweight, short gestation, and household air pollution were the top risk factors for meningitis-related mortality. Interpretation: Although mortality and incidence have declined significantly since 1990, progress is insufficient to meet WHO 2030 targets. Despite marked progress in reducing bacterial meningitis via global vaccination campaigns, a substantial meningitis burden persists, attributable both to common pathogens such as S pneumoniae and N meningitidis and to emerging non-bacterial pathogens such as Candida spp and drug-resistant fungi. Achieving WHO goals will require sustained investment in surveillance, vaccination, maternal screening, and health-system strengthening, especially in high-burden settings. Funding: Gates Foundation, Wellcome Trust, and UK Department of Health and Social Care.
AB - Background: Meningitis remains the leading infectious cause of neurological disabilities globally, disproportionately affecting children younger than 5 years and populations in the African meningitis belt. Whereas previous global estimates focused on ten pathogen categories, this study presents the most comprehensive analysis to date, assessing the meningitis burden attributable to 17 causative pathogens based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework. Methods: GBD is a systematic, scientific effort aimed at quantifying the comparative magnitude of health loss caused by diseases, injuries, and risk factors across age groups, sexes, and geographical locations over time. We estimated meningitis mortality using the Cause of Death Ensemble model (CODEm) and morbidity using DisMod-MR 2.1, incorporating data from vital registration, verbal autopsy, surveillance, hospital data, and systematic reviews. Aetiology-specific estimates were generated with pathogen-linked case-fatality ratios and splined binomial regression models. Risk factor attribution was based on established risk–outcome pairs and population attributable fractions. Findings: In 2023, there were 259 000 (95% uncertainty interval 202 000–335 000) global deaths and 2·54 million (2·20–2·93) incident cases of meningitis. Children younger than 5 years accounted for more than a third of deaths (86 600 [53 300–149 000]). Streptococcus pneumoniae, Neisseria meningitidis, non-polio enteroviruses, and other viruses were the leading causes of death, while non-polio enteroviruses caused the most cases. The four WHO-defined preventable meningitis pathogens of interest (S pneumoniae, N meningitidis, Haemophilus influenzae, and Group B streptococcus) contributed to 98 700 deaths (77 000–127 000) and 594 000 cases (514 000–686 000). Low birthweight, short gestation, and household air pollution were the top risk factors for meningitis-related mortality. Interpretation: Although mortality and incidence have declined significantly since 1990, progress is insufficient to meet WHO 2030 targets. Despite marked progress in reducing bacterial meningitis via global vaccination campaigns, a substantial meningitis burden persists, attributable both to common pathogens such as S pneumoniae and N meningitidis and to emerging non-bacterial pathogens such as Candida spp and drug-resistant fungi. Achieving WHO goals will require sustained investment in surveillance, vaccination, maternal screening, and health-system strengthening, especially in high-burden settings. Funding: Gates Foundation, Wellcome Trust, and UK Department of Health and Social Care.
UR - https://www.scopus.com/pages/publications/105038249924
U2 - 10.1016/S1474-4422(26)00101-8
DO - 10.1016/S1474-4422(26)00101-8
M3 - Article
C2 - 41911930
AN - SCOPUS:105038249924
SN - 1474-4422
JO - The Lancet Neurology
JF - The Lancet Neurology
ER -