Trends in the global burden of childhood meningitis between 1990 and 2021 and projections to 2035: based on the global burden of diseases database 2021

OBJECTIVE: This study aimed to assess trends in the incidence, mortality and disability-adjusted life years (DALYs) of meningitis in children aged 0-14 years between 1990 and 2021 worldwide. METHODS: This study analysed the incidence, mortality and DALYs of meningitis in children aged 0-14 years in 204 countries between 1990 and 2021 and used a mixed effects regression model to calculate the average annual percentage change. The Markov chain Monte Carlo method was used to quantify uncertainty (95% uncertainty interval). RESULTS: In 2021, the global incidence of meningitis in children aged 0-14 years was 66.24 per 100,000, and the mortality rate was 5.59 per 100,000. Between 1990 and 2021, the global incidence decreased by 282.70%, and the mortality rate decreased by 310.8%. The incidence and mortality rates were highest in neonates and children aged 1-5 months, at 1,185.02 per 100,000 and 541.35 per 100,000, respectively. According to the socio-demographic index (SDI) stratifications, low SDI areas have the heaviest burden. Pathogen analysis showed that the main pathogens causing meningitis in children aged 0-14 years worldwide in 2021 included Streptococcus pneumoniae, Neisseria meningitidis and Klebsiella pneumoniae, of which S. pneumoniae caused 1.69632 million DALYs, N. meningitidis caused 1.41484 million DALYs and K. pneumoniae caused 1.19393 million DALYs. By 2035, N. meningitidis will become the main pathogen. CONCLUSION: The burden of meningitis in children has decreased significantly worldwide, but those in low-income areas and newborns still face severe challenges. Streptococcus pneumoniae, N. meningitidis and K. pneumoniae are the main pathogens.