부산대학교 도서관

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.
Competing Interests: Declaration of interests K Akinosoglou reports payment or honoraria for lectures, presentations, speakers’ bureau fees, manuscript writing or educational events from Pfizer Hellas, Gilead Sciences, Merck Sharp and Dohme, Glaxosmithkline Greece, as payments to the University of Patras; and support for attending meetings or travel, or both, to Pfizer Hellas, Gilead Sciences, Merck Sharp and Dohme, Glaxosmithkline Greece, and Norma Hellas; all outside the submitted work. R Ancuceanu reports payment or honoraria for lectures, presentations, speakers’ bureau fees, manuscript writing or educational events from AbbVie, Sandoz, B. Braun, and Laropharm, all outside the submitted work. S Bhaskar reports leadership or fiduciary roles in other board, society, committee or advocacy groups, paid or unpaid, with Rotary Club of Sydney, Australia as Board Director, with Rotary District 9675, Australia as Chair of Diversity Equity & Inclusion, and with Global Health Hub, Berlin as Founding Member/Chair & Co-Manager, Global Health and Migration Hub Community, all outside the submitted work. D Buonsenso reports payment or honoraria for lectures, presentations, speakers bureau fees, manuscript writing or educational events and participation on an advisory board from Pfizer for the Pneumococcal 22 Vaccine Advisory Board 2022, outside the submitted work. A Demetriades reports payment or honoraria for speakers’ bureau fees from Integra, Stryker, and Safe Orthopaedics; leadership or fiduciary roles, unpaid, as a board member (non-stipendiary) with the European Association of Neurosurgical Societies, Global Neuro Foundation and on the steering committee (non-stipendiary) of AO Spine Knowledge Forum Degenerative; all outside the submitted work. B D Gessner reports support for the present manuscript from Pfizer through salary payments; and stock or stock options through their employment with Pfizer; all outside the submitted work. N E Ismail reports a leadership or fiduciary role as an unpaid council member and bursar of the Malaysian Academy of Pharmacy, outside the submitted work. J J Jozwiak reports payment or honoraria for lectures, presentations, speakers’ bureau fees, manuscript writing or educational events from Novartis and Adamed as personal payments, outside the submitted work. K Krishan reports non-financial support from the UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. A-F A Mentis reports grants or contracts from “MilkSafe: A novel pipeline to enrich formula milk using omics technologies”, a research co financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH-CREATE - -INNOVATE (project code: T2EDK-02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860); payment for expert testimony as a peer-reviewer for Fondazione Cariplo, Italy; leadership or fiduciary roles in other boards, societies, committees or advocacy groups, paid or unpaid, by serving as Editorial Board Member for the journals Systematic Reviews and Annals of Epidemiology, and as Associate Editor for Translational Psychiatry; stocks in a family winery; and other financial or non-financial interests as a scientific officer with the BGI Group; all outside the submitted work. M J Postma reports stock or stock options from Health-Ecore (Zeist NL, 25%) and PAG BV (Groningen, NL, 100%) outside the submitted work. S Shrestha reports other financial interests in the School of Pharmacy at Monash University Malaysia by receiving the Graduate Research Merit Scholarship to pursue his PhD, outside the submitted work. L Silva reports grants or contracts from CENTRO-04-3559-FSE-000162, Fundo Social Europeu, outside the submitted work. J A Singh reports consulting fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs, Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM, Trio Health, Medscape, WebMD, and Practice Point Communications, the National Institutes of Health, and the American College of Rheumatology; payment or honoraria for speakers’ bureau fees from Simply Speaking; support for attending meetings or travel from the steering committee of OMERACT; participation on a Data Safety Monitoring Board or Advisory Board with the US Food and Drug Administration Arthritis Advisory Committee; a leadership or fiduciary role in board, society, committee or advocacy group, paid or unpaid, with OMERACT as a steering committee member, with the Veterans Affairs Rheumatology Field Advisory Committee as Chair (unpaid), and with the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis and as editor and director (unpaid); stock or stock options in TPT Global Tech, Vaxart Pharmaceuticals, Aytu BioPharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings, and previously owned stock options in Amarin, Viking, and Moderna Pharmaceuticals; all outside the submitted work. C Wright is an employee of Meningitis Research Foundation, which receives grants in support of their charitable objectives from GlaxoSmithKline, Pfizer, Sanofi Pasteur, Serum Institute, and the Tableau Foundation, outside the submitted work.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)