Global, regional, and national burden of meningitis, its risk factors, and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Sirota, S.B.; Bender, R.G.; Dominguez, R.V.; Vongpradith, A.; Movo, A.; Swetschinski, L.R.; Araki, D.T.; Han, C.; Wool, E.E.; A. J. Jabbar, A.; Aalipour, M.A.; Aalruz, H.; Abbasi, M.; Abbasifard, M.; Abbaspour, F.; Abbastabar, H.; Abd Elhafeez, S.; Abdalla, M.A.; Abdallah, E.M.; Abdel Razeq, N.M.I.; Abd-Elsalam, S.; Abdelwahab, O.A.; Abdoun, M.; Abdous, A.; Abdrabou, M.M.; Abdul Aziz, J.M.; Abdulkader, R.S.; Abdullahi, A.; Abdulmalik, A.E.; Abdulrahman, R.F.; Abdul-Rahman, T.; Abedi, A.; Abejew, A.A.; Abidi, S.H.; Abil, O.Z.; Abiodun, O.; Abo Kasem, R.; Aboagye, R.G.; Abolhassani, H.; Aborode, A.T.; Abourashed, N.M.; Abtahi, D.; Abu, Z.; Abu Farha, R.K.; Abu Rumeileh, S.; Abuadas, F.H.A.; Abubakar, A.K.; Abubakar, I.B.; Abu-Elala, N.; Abu-Gharbieh, E.; Abuhammad, S.; Abuhelwa, A.Y.; Abukhadijah, H.J.; Abushanab, D.; Acharya, A.B.; Acharya, K.P.; Acharya, S.; Achore, M.; Adams, L.C.; Addo, I.Y.; Adedia, D.; Adedokun, K.A.; Adegboye, O.A.; Adegoke, N.A.; Adekanmbi, V.; Adeleke, O.T.; Adesina, M.A.; Adesola, R.O.; Adetunji, J.B.; Adewumi, I.P.; Adeyeoluwa, T.E.; Adiba, A.; Adiga, U.; Adnan, M.; Adnani, Q.E.S.; Adoma, P.O.; 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doi:10.1016/s1474-4422(26)00101-8

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.

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Global, regional, and national burden of meningitis, its risk factors, and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Sirota, Sarah Brooke;Bender, Rose Grace;Dominguez, Regina-Mae Villanueva;Vongpradith, Avina;Movo, Amanda;Swetschinski, Lucien R;Araki, Daniel T;Han, Chieh;Wool, Eve E;A. J. Jabbar, Ahmed;Aalipour, Mohammad Amin;Aalruz, Hasan;Abbasi, Madineh;Abbasifard, Mitra;Abbaspour, Faezeh;Abbastabar, Hedayat;Abd ElHafeez, Samar;Abdalla, Mohammed Altigani;Abdallah, Emad M.;Abdel Razeq, Nadin M. 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Augello;Aujayeb, Avinash;Aurangzeb, Khursheed;Awan, Sana Javaid;Awoke, Andargie Abate;Ayipo, Yusuf Oloruntoyin;Azad, AKM;Azadnia, Arian;Azargoonjahromi, Ali;Aziz, Sadat Abdulla;Azizan, Amin;Babu, Giridhara Rathnaiah;Badar, Muhammad;Badran, Alaa Aboelnour;Baghlaf, Khlood K;Bahreini, Razieh;Baig, Atif Amin;Bakhshali, Mohamad Amin;Balakrishnan, Senthilkumar;Balooch Hasankhani, Mohammadreza;Barac, Aleksandra;Barati, Shirin;Bardhan, Mainak;Barker-Collo, Suzanne Lyn;Barqawi, Hiba Jawdat;Barrow, Amadou;Bashir, Muhammad Irfan;Bashiri, Azadeh;Basri, Rehana;Bassat, Quique;Bastan, Mohammad-Mahdi;Batchu, Sai;Bathini, Prapthi Persis;Batiha, Abdul-Monim;Batra, Ravi;Bayat, Mahdis;Bazaid, Abdulrahman S;Bedi, Neeraj;Beeraka, Narasimha M;Behjati, Jina;Behzadi, Payam;Belayneh, Asnake Gashaw;Belayneh, Melesse;Bele, Samir;Bello, Muhammad Bashir;Bello, Olorunjuwon Omolaja;Beloukas, Apostolos;Bente Kamal Tune, Samiun Nazrin;Berihun, Abiye Assefa;Bermudez, Amiel Nazer C;Bettencourt, Paulo J G;Bhargava, Ashish;Bhaskar, Sonu;Bhatnagar, Arushee;Bhattacharjee, Priyadarshini;Bhattacharjee, Shuvarthi;Bhattarai, Ashmin Hari;Bhatti, Gurjit Kaur;Bhatti, Manpreet Singh;Birru, Eshetie Melese;Bodhare, Trupti;Boloor, Archith;Bolourinejad, Paria;Borran, Mina;Bosoka, Samuel Adolf;Botero Carvajal, Alejandro;Bouaoud, Souad;Boukhiam, Meriem;Briko, Nikolay Ivanovich;Brown, Colin Stewart;Bui, Linh Phuong;Busch, Felix;Bustanji, Yasser;Cámera, Luis Alberto;Capodici, Angelo;Carugno, Andrea;Carvalheiro, Cristina G;Carvalho, Felix;Catalá-López, Ferrán;Cegolon, Luca;Cenderadewi, Muthia;Cernigliaro, Achille;Chadwick, Joshua;Chakraborty, Chiranjib;Chakraborty, Sandip;Chattu, Vijay Kumar;Chau, Lam Duc;Chaudhary, Anis Ahmad;Chaudhuri, Sirshendu;Chaurasia, Prof. Akhilanand;Chen, Hana;Chen, Haowei;Chen, Hui;Chew, Nicholas WS;Ching, Patrick R;Cho, William C S;Chong, Bryan;Chopra, Hitesh;Chu, Dinh-Toi;Chuang, Ting-Wu;Chukwu, Chidozie Williams;Chung, Eric;Chung, Sunghyun;Cosma, Claudia;Cruz-Martins, Natalia;Dadras, Omid;Dagnew, Ephrem Mebratu;Dagnew, Mulat Teferi;Dai, Xiaochen;D'Amico, Emanuele;Damtew, Yohannes Tefera;Dang, Anh Kim;Daniel, Roy Arokiam;D'Anna, Lucio;Danpanichkul, Pojsakorn;Danso, Samuel E;Darcho, Samuel Demissie;Dardas, Latefa Ali;Darwesh, Aso Mohammad;Das, Saswati;Davletov, Dimash;Deekonda, Sindhura;Del Riccio, Marco;Delgado-Enciso, Ivan;Demeke, Dessalegn;Demetriades, Andreas K;Derese, Tadios Niguss;Dervišević, Emina;Dervišević, Muamer;Desalegn, Girmay;Desalegn, Mitiku;Devanbu, Vinoth Gnana Chellaiyan;Devarakonda, Pradeep Kumar;Devegowda, Devananda;Dewan, Syed Masudur Rahman;Dhali, Arkadeep;Dhane, Amol S;Dhimal, Mandira Lamichhane;Dhimal, Meghnath;Dhingra, Sameer;Di Bella, Stefano;Di Martino, Giuseppe;Di Paolo, Antonello;Di Pumpo, Marcello;Dias da Silva, Diana;Do, Hoa Thi;Do, Huyen Phuc;Do, Mai Ngoc;Do, Thao Huynh Phuong;Dohare, Sushil;Dokova, Klara Georgieva;Dolecek, Christiane;Dorostkar, Fariba;dos Santos, Wendel Mombaque;Doshi, Ojas Prakashbhai;Dowou, Robert Kokou;Dsouza, Ashel Chelsea;Dubljanin, Eleonora;Dunne, Jennifer;Duraisamy, Senbagam;Durojaiye, Oyewole Christopher;Dutta, Siddhartha;Ebohon, Osamudiamen;Eckmanns, Tim;Ed-Dra, Abdelaziz;Edeh, Cynthia;Efendi, Ferry;Ekapirat, Nattwut;Ekholuenetale, Michael;Eko, Seraphine Mojoko;Ekundayo, Temitope Cyrus;El Arab, Rabie Adel;El Bayoumy, Ibrahim Farahat;El Sayed Zaki, Maysaa;Eldaboush, Ahmed;Elhadi, Muhammed;Elhadi, Yasir Ahmed Mohammed;Elhoumed, Mohamed;Elias, Christelle;Elmeligy, Omar Abdelsadek Abdou;Elnaem, Mohamed Hassan;Elshaer, Mohammed;Elsohaby, Ibrahim;Eltaha, Chadi;Eltahawy, Abdelgawad Salah;Esezobor, Christopher Imokhuede;Eslami, Majid;Fadavian, Heidar;Fagbamigbe, Adeniyi Francis;Fan, Qiping;Faraji, Niloofar;Fareed, Mohammad;Fares, Jawad;Farhana, Aisha;Fasina, Folorunso Oludayo;Fasina, Modupe Margaret;Fatima, Zareen;Feasey, Nicholas A;Fekadu, Gelana;Fekadu, Ginenus;Ferrara, Pietro;Ferreira, Nuno;Fetensa, Getahun;Fiorilla, Claudio;Fischer, Florian;Fonzo, Marco;Fortuna Rodrigues, Celia;Foschi, Matteo;G, Sridevi;Gaal, Peter Andras;Gadanya, Muktar A;Gajdács, Márió;Ganapathy, Dhanraj;Gangachannaiah, Shivaprakash;Gao, Xiang;Garba, Bashiru;Garcia-Azorin, David;Garlasco, Jacopo;Gautam, Rupesh K;Gazzelloni, Federica;Gebre, Feven Sahle;George, Nsikakabasi Samuel;Gessner, Bradford D;Getahun, Genanew K;Gete, Kalab Yigermal;Ghadiri, Keyghobad;Ghaffari, Kazem;Ghamkhar, Arin;Gharaibeh, Lobna;Ghasemi, Moein;Ghazy, Ramy Mohamed;Ghodrati, Arshia;Gholizadeh, Nasim;Gilani, Jaleed Ahmed;Gilani, Syed Abdullah;Giri, Bikash Ranjan;Girombelli, Alessandro;Göbölös, Laszlo;Gohari, Kimiya;Golechha, Mahaveer;Goleij, Pouya;Goshu, Yitayal Ayalew;Guarducci, Giovanni;Gubari, Mohammed Ibrahim Mohialdeen;Gulma, Kabiru Abubakar;Gunawardane, Damitha Asanga;Guo, Zheng;Gupta, Anish Kumar;Gupta, Lalit;Gupta, Sapna;Gupta, Swati;Gupta, Vivek Kumar;Gutiérrez-Murillo, Roberth Steven;Guzman-Esquivel, Jose;Habibzadeh, Adrina;Habteyohannes, Awoke Derbie;Hadei, Mostafa;Hadi, Najah R;Hadian, Zahra;Hagos Gebrehiwot, Zerai;Hai Nam, Nguyen;Haile, Addisalem;Hailu, Kirubel Tesfaye;Halboup, Abdulsalam M;Halder, Pritam;Halil, Hassen Mosa;Hamad, Islam M;Hamdy, Nadia M;Hamed, Mohamed;Hameed, Sajid;Hanif, Asif;Hankey, Graeme J;Harboe, Zitta Barrella;Haro, Josep Maria;Harsini, Sara;Has, Eka Mishbahatul Marah;Hasaballah, Ahmed I;Hasan, Ikramul;Hasan, Md Kamrul;Hasani, Hamidreza;Hashempur, Mohammad Hashem;Hasnain, Md Saquib;Hassan, Amr;Hassan, Ibrahim Nagmeldin;Hassan, Nageeb;Hayat, Khezar;He, Jiawei;Heibati, Behzad;Heidari, Mohammad;Helmy, Yosra A.;Hendy, Abdelaziz;Herteliu, Claudiu;Hesari, Marjan;Heyderman, Robert Simon;Hezam, Kamal;Hiraike, Yuta;Holla, Ramesh;Holler, Jon Gitz Gitz;Hossain, Md Sabbir;Hosseinzadeh, Mehdi;Hostiuc, Mihaela;Hostiuc, Sorin;Huang, Junjie;Hushmandi, Kiavash;Hussain, Javid;Hussein, Dursa;Hussein, Nawfal R;Husseiny, Mohamed Ibrahim;Huynh, Hong-Han;Ibitoye, Segun Emmanuel;Ibragimova, Liliya;Ibrahim, Khalid S;Ibrahim, Umar Idris;Ibrayeva, Anel;Ikiroma, Adalia;Ikuta, Kevin S;Ilesanmi, Olayinka Stephen;Ilic, Irena M;Ilic, Milena D;Ilyas, Muhammad Hamza;Ilyasu, Salim;Imam, Mohammad Tarique;Inok, Arit;Irham, Lalu Muhammad;Isa, Mustafa Alhaji;Ishaqui, Azfar Athar;Islam, Md Rabiul;Islam, Md. Shahinul;Ismael, Shameeran Salman;Ismail, Faisal;Ismail, Nahlah Elkudssiah;Ismoldayev, Yerlan;Iwu, Chidozie Declan;Jadidi, Ali;Jafari, Mohammadsadegh;Jaganathan, Vennila;Jahrami, Haitham;Jairoun, Ammar Abdulrahman;Jaiswal, Swati;Jakovljevic, Mihajlo;JALAL, MOHAMMAD SHAH;Jalloh, Mohamed;Jamal, Armaan;Jamal, Qazi Mohammad Sajid;James, Jerin;Jamora, Roland Dominic G;Jarrahi, Esmaeil;Javidnia, Javad;Jawaid, Talha;Jawell Odah Abed, Qassim;Jayapala, Deepan Pamoda;Jayasinghe, Ruwan Duminda;Jayasinghe, Yovanthi Anurangi;Jeon, Jae Joon;Jeong, Gwang Hun;Jeong, Seogsong;Jiang, Min;Jin, Wenyi;Jokar, Mohammad;Jomehzadeh, Nabi;Jonas, Jost B;Joo, Tamas;Jose, Jobinse;Joseph, Akaninyene Paul;Joseph, Mickael Antoine;Joseph, Nitin;Joshi, Krupal;Joshua, Charity Ehimwenma;Jozwiak, Jacek Jerzy;Kaambwa, Billingsley;Kadashetti, Vidya;Kadir, Dler H. Hussein;Kadir, Mohammad Fahim;Kakkar, Ashish Kumar;Kalani, Rizwan;Kalavani, Khalil;Kamal, Mehnaz;Kamorudeen, Ramat T.;Kang, Jiseung;Kankam, Samuel Berchi;Kanmodi, Kehinde Kazeem;Kannan S, Suthanthira;Kar, Dattatreya;Karajizadeh, Mehrdad;Karakasis, Paschalis;Karami, Jafar;Karampoor, Sajad;Karch, André;Karimi Behnagh, Arman;Karobari, Mohmed Isaqali;Karpiński, Tomasz M. M;Kashoo, Faizan Zaffar;Kashyap, Manoj Kumar;Kausar, Mohd Adnan;Kazemi, Foad;Kebede, Abenezer Zenebe;Kebede, Hafte Kahsay;Kebede, Yabets Tesfaye;Keivanlou, Mohammad-Hossein;Kempen, John H;Keshwani, Ariz;Khader, Yousef Saleh;Khajuria, Himanshu;Khalifa, Hazim O.;Khalil, Anees Ahmed;Khamesipour, Faham;Khan, Ajmal;Khan, Faiz Ullah;Khan, Iman Waheed;Khan, Iqra Hamid;Khan, Maseer;Khan, Mohammad Idreesh;Khan, Muhammad Umer;Khan, Ramsha Mushtaq;Khan, Sumaiya;Khan, Ubaid;Khan, Yusuf Saleem;Khan, Zahid;Khanal, Vishnu;Khasbage, Sameer Uttamaro;Khatatbeh, Haitham;Khatatbeh, Moawiah Mohammad;Khayat Kashani, Hamid Reza;Kheirallah, Khalid A;Kheradmand, Daniel;Khoshvaght, Parisa;Khoshvaght, Samira;Khosravi, Farbod;Khosravi, Sepehr;Khubchandani, Jagdish;Kim, Grace;Kim, Hye Jun;Kim, Min Seo;Kim, Yun Jin;Kimokoti, Ruth W;Kisa, Adnan;Kisa, Sezer;Kishore, Ladli;Kitaw, Tegene Atamenta;KM, Shivakumar;Kolahi, Ali-Asghar;Kolieghu Tcheumeni, Diana Gladys;Kompani, Farzad;Korma, Wolyu Erkano;Korshunov, Vladimir Andreevich;Korzh, Oleksii;Kretchy, James-Paul;Krishan, Kewal;Kuddus, Mohammed;Kuitunen, Ilari;Kulimbet, Mukhtar;Kulshreshtha, Shweta;Kumah, Emmanuel;Kumar, Chandan;Kumar, Dewesh;Kumar, Jogender;Kumar, Kamal;Kumar, Narendar;Kumar, Sanjay Kirshan;Kumar, Tushar;Kumar, Vijay;Kumar, Vikash;Kundu, Satyajit;Kunjavara, Jibin;Kurmi, Om P;Kushawaha, Pramod Kumar;Kusuma, Dian;Kuttybayev, Assylkhan;Kytö, Ville;La Vecchia, Adriano;Lahariya, Chandrakant;Lakanova, Balzhan;Laksono, Tri;Lanfranchi, Francesco;Lau, Colleen L;Lawanson, Teniola;Lazarus, Eilean Rathinasamy;Le, Duc Huy;Le, Huyen Thi Thanh;Le, Minh Huu Nhat;Le, Nhi Huu Hanh;Le, Thao Thi Thu;Ledda, Caterina;Lee, Sergey Vadimovich;Lee, Seung Won;Lee, Wei-Chen;Leivaditis, Vasileios;Lemma, Dawit Alemu;Li, Xiaopan;Lin, Jialing;Liu, Gang;Liu, Haipeng;Liu, Jue;Liu, Xuefeng;Liu, Zhe;Llanaj, Erand;Lodhi, Madeeha Shahzad;Loftus, Michael J;Lopukhov, Platon D;Lovering, Edward;Lubinda, Jailos;Lucchetti, Giancarlo;Luo, Peng;Lutambi, Angelina M;Lutzky Saute, Ricardo;Lytvyak, Ellina;M. Amin, Hawraz Ibrahim;M. Hussein, Ali;Ma, Kevin Sheng-Kai;Ma, Zheng Feei;Mabrok, Mahmoud;Madureira-Carvalho, Aurea Marilia;Magwe, Edward Augustine;Mahalingam, Sasikumar;Mahalleh, Mehrdad;Mahmood, Nozad Hussein;Majidnia, Mostafa;Malhotra, Hardeep Singh;Malik, Ahmad Azam;Malik, Farihah;Malik, Shahid;Malik, Tabarak;Malkamu, Birhanemaskal;Manilal, Aseer;Mansoor, Farheen;Manzoor, Shaista;Maqbool, Tahir;Marasini, Bishnu P;Marateb, Hamid Reza;Margetis, Konstantinos;Marks-Hultström, Michael;Martinez-Guerra, Bernardo Alfonso;Martins-Melo, Francisco Rogerlândio;Martorell, Miquel;Marzo, Roy Rillera;Marzouk, Sammer;Masoumi-Asl, Hossein;Mathangasinghe, Yasith;Mathur, Neeta;Matozinhos, Fernanda Penido;Maude, Richard James;Mayaki, Suleiman;McPhail, Steven M;Mediratta, Rishi P;Mehari, Medhin;Mehmood, Asim;Mehto, Subhash;Mekene Meto, Tesfahun;Meles, Hadush Negash;Melese, Addisu;Memish, Ziad Ahmed;Mendoza, Walter;Menezes, Godfred Antony;Mengistie, Emiru Ayalew;Mengstie, Leweyehu Alemaw;Mercogliano, Michelangelo;Meretoja, Atte;Merza, Muayad Aghali;Mestrovic, Tomislav;Mettananda, Chamila Dinushi Kukulege;Mettananda, Sachith;Metwally, Mohamed M. M.;Mewoabi, Sandrine Donfack D;Miazgowski, Bartosz;Michalek, Irmina Maria;Mihretie, Kebadnew Mulatu;Mikrajab, Muhammad Agus Naufal;Minervini, Giuseppe;Misra, Arup Kumar;Modi, Dhruti;Mohamed, Mona Gamal;Mohamed, Nouh Saad;Mohamed Ahmed, Khabab Abbasher Hussien;Mohammad, Taj;Mohammadi, Abdolreza;Mohammadi, Mohammad Reza;Mohammadi, Saeed;Mohammadzadeh, Ibrahim;Mohammed, Abdulwase;Mohammed, Omer;Mohammed, Shafiu;Mohammed, Yahaya;Mohan, Syam;Mohanta, Yugal Kishore;Mohsenzadeh, Amin;Mokdad, Ali H;Mollaei, Amirabbas;Monasta, Lorenzo;Mondal, Himel;Moni, Mohammad Ali;Montalti, Marco;Moore, Catrin E;Moradi-Lakeh, Maziar;Morovvati, Mahdis;Morrison, Shane Douglas;Morsy, Mahmoud M;Mosaddeghi Heris, Reza;Motappa, Rohith;Mousavi, Fatemeh;Mousavi Khaneghah, Amin;Mousavi Kiasary, Seyed Mohamad Sadegh;Mousnad, Mohamed Awad Abdalaziz;Mowafy, Hagar L.;Mozahheb Yousefi, Kimia;Mozart Vieira, Nicollas;Msherghi, Ahmed;Mturi, Florence Neema;Mubarik, Sumaira;Muccioli, Lorenzo;Mudhune, Godfrey;Muhammad, Jibran Sualeh;Mulatu, Sileshi;Mulita, Francesk;Muniyandi, Malaisamy;Munjal, Kavita;Murillo-Zamora, Efren;Murugan, Vignesh;Musa, Sani;Muthu, Sathish;Muthupandian, Saravanan;Muvunyi, Claude Mambo;Muzaffar, Muhammad;Myung, Woojae;Nabi Foodani, Mahdi;Nagarajan, Ahamarshan Jayaraman;Nagarajan, Karikalan;Naguib, Ghada;Nainu, Firzan;Najmuldeen, Hastyar Hama Rashid;Nakhostin Ansari, Noureddin;Naqid, Ibrahim A;Nargus, Shumaila;Nashwan, Abdulqadir J;Nasiri, Hamide;Nassar, Mahmoud;Natto, Zuhair S;Naureen, Zakira;Naveed, Muhammad;Nawaz, Anum;Nayak, Biswa Prakash;Nazari, Javad;Nchanji, G. Takop;Nega, Amanuel Tebabal;Negash, Abigia Ashenafi;Negoi, Ionut;Nekliudov, Nikita;Nepal, Gaurav;Nepal, Samata;Netsere, Henok Biresaw;Newton, Charles Richard James;Ngabonziza, Jean Claude Semuto;Nguyen, Cuong Tat;Nguyen, Cuong Tat;Nguyen, Hien Thu;Nguyen, Huong Lan Thi;Nguyen, Tham Thi;Nguyen, Trang;Nguyen, Tu Anh;Nguyen, Van Thanh;Niazi, Robina Khan;Nikoobar, Ali;Niranjan, Vikram;Niyonsenga, Jean Marie Vianney;Nomura, Shuhei;Nawsherwan, null;Nri-Ezedi, Chisom Adaobi;Nshimiyimana, Jean Claude;Nugen, Fred;Nwakama, Chijindu N;Nyande, Felix Kwasi;Nzoputam, Chimezie Igwegbe;Nzoputam, Ogochukwu Janet;Oancea, Bogdan;Oddi, Fabio Massimo;Oduro, Michael Safo;Ofakunrin, Akinyemi O D;Ogundijo, Oluwaseun Adeolu;Ojedoyin, Olusegun Olatunji;Ojo-Akosile, Tolulope R;Okeke, Sylvester Reuben;Okeke-Obayemi, Deborah Oluwatosin;Okonji, Osaretin Christabel;Okunlola, Oluyemi Adewole;Olagunju, Andrew T;Olawuyi, Abdullahi Olaleye;Olorukooba, Abdulhakeem Abayomi;Omar, Goran Latif;Onyedibe, Kenneth Ikenna;Ordak, Michal;Orscelik, Atakan;Ortiz-Prado, Esteban;Osborne, Augustus;Osei, Eric;Osuagwu, Uchechukwu Levi;Osuolale, Olayinka;Otorkpa, Oche Joseph;Ouyahia, Amel;Owusu, Irene Amoakoh;Oyebanji, Oladayo Ayobami;Oyebola, Kolapo;Oyelade, Tope;Oyeleye, Ayotunde Eniola;Oyeniran, Kehinde Adewole;Oyeyemi, Oyetunde T;P A, Mahesh;Padubidri, Jagadish Rao;Pana, Adrian;Panda, Sujogya Kumar;Pandey, Ashok;Pandi-Perumal, Seithikurippu R;Pandya, Apurvakumar;Panos, Georgios D;Panos, Leonidas D;Paolino, Giovanni;Papa, Mario Virgilio;Papadimopoulos, Ilias;Paranjkhoo, Parinaz;Pardhan, Shahina;Parida, Amrita;Parikh, Romil R;Park, Chulwoo;Pasovic, Maja;Patel, Bhumi Hemal;Patel, Mitesh;Patel, Neel Navinkumar;Patel, Satyananda;Patil, Shankargouda;Patoulias, Dimitrios;Pawar, Shrikant;Pawar, Shubhadarshini;Pekarcikova, Jarmila;Pensato, Umberto;Peprah, Prince;Pereira, Gavin;Perez Chacon, Gladymar;Perna, Simone;Petakh, Pavlo;Peter, Olumuyiwa James;Pham, Hai Quang;Philip, Anil K;Piracha, Zahra Zahid;Pirera, Edoardo;Plotnikov, Evgenii;Poddighe, Dimitri;Polibin, Roman V;Pollard, Andrew;Poluru, Ramesh;Porntaveetus, Thantrira;Pourasghary, Sajjad;Pourghazi, Farzad;Pradhan, Pranil Man Singh;Pradipta, Rifky Octavia;Prashant, Akila;Prates, Elton Junio Sady;Puvvula, Jagadeesh;Qamar, Farah N;Qasim, Nameer Hashim;Qi, Xiang;Qur'aniati, Nuzul;Qurashi, Shahazad Niwazi;Rabiee, Navid;Rabiu, Akeem Ganiyu Ganiyu;Rachmat, Basuki;Radhakrishnan, Raghu Anekal;Radhakrishnan, Venkatraman;Raggi, Alberto;Raghav, Pankaja;Raghav, Yashpal Singh Raghav;Raghuveer, Pracheth;Rahamon, Sheu Kadiri;Rahim, Hawbash Mohammed-Amin;Rahimi, Sajjad;Rahimi-Movaghar, Vafa;Rahman, Fryad Majeed;Rahman, Mosiur;Rahman, Muhammad Aziz;Rahmoune, Hakim;Raina, Sunil Kumar;Raj, Jeffrey Pradeep;Raja, Adarsh;Rajendran, Judah;Rajindrajith, Shaman;Rajizadeh, Mohammad Amin;Rakhimov, Kairolla Dyusenbayevich;Ramadan, Mahmoud Mohammed;Ramasamy, Chitra;Ramasamy, Shakthi Kumaran;Ramzan, Muhammad;Rancic, Nemanja;Ranjbar Noei, Fatemeh;Rao, Asad Gul;Rao, Sowmya J;Rasouli-Saravani, Ashkan;Rathi, Isha;Rathish, Devarajan;Rauniyar, Santosh Kumar;Rautalin, Ilari;Rawaf, David Laith;Rawaf, Salman;Razi, Bahman;Redwan, Elrashdy M.;Reta, Melese Abate;Reyes, Luis Felipe;Rezaei, Mina;Rezaei, Nazila;Rezaeian, Mohsen;Riaz, Muhammad;Rocke, Tamarie Pearl;Rodriguez, Jefferson Antonio Buendia;Roever, Leonardo;Rohilla, Ravi;Romadlon, Debby Syahru;Rony, Moustaq Karim Khan;Rosenthal, Victor D;Ross, Allen Guy Patrick;Rout, Himanshu Sekhar;Roy, Adrija;Roy, Parimal;Roy, Priyanka;Roy, Sharmistha;Roy, Shubhanjali;Roy Chowdhury, Susovan;Rubeshkumar, Polani;Ruela, Guilherme de Andrade;Runghien, Tilleye;Rustagi, Neeti;S N, Chandan;Saad, Aly M A;Saad, Mohamed Omar;Saad Eddin, Adnan;Sabbatucci, Michela;Saber-Ayad, Maha Mohamed;Sabet, Cameron John;Sabour, Siamak;Sachdeva Dhingra, Mamta;Sadat Rafiei, Seyed Kiarash;Saddique, Muhammad Nabeel;Sadee, Bashdar Abuzed;Sadeghi, Ehsan;Sadek, Bassem;Sadr, Hossein;Saeed, Mohd;Saeed, Umar;Saeedi, Maryam;Safari, Mehdi;Sagharichi, Mastooreh;Saghazadeh, Amene;Sah, Ashok Kumar;Saheb Sharif-Askari, Fatemeh;Saheb Sharif-Askari, Narjes;Sahebkar, Amirhossein;Sahu, Monalisha;Sahu, Sushil Kumar;Saki, Morteza;Sakshaug, Joseph W;Salam, Nasir;Salameh, Mohammed;Salami, Afeez Abolarinwa;Saleem, Rahman Shah Zaib;Saleem, Zikria;Saleh, Mohamed A;Salehi, Mahdi;Saliev, Timur;Salimi, Sohrab;Sallam, Malik;Samodra, Yoseph Leonardo;Samy, Abdallah M;Sangle, Sandeep G;Sanjeev, Rama Krishna;Sankar, Sathish;Sanker, Vivek;Saravanan, Aswini;Sarmadi, Mohammad;Sarode, Gargi Sachin;Sarode, Sachin C;Sartorius, Benn;Sassano, Michele;Sathya Narayanan, Mukesh Kumar;Satpathy, Maheswar;Savabi Far, Mehrdad;Schinckus, Christophe;Schwarz, Ghil;Sejben, Anita;Selvaraj, Siddharthan;Semenova, Yuliya;Sendekie, Ashenafi Kibret;Senthilkumaran, Subramanian;Serban, Dragos;Sethi, Yashendra;Seyed Alshohadaei, Seyed Mohammad;Seyedi, Dina;Seylani, Allen;Shaalan, Yara;Shahid, Samiah;Shahid, Syed Ahsan;Shahid, Wajeehah;Shahini, Endrit;Shahwan, Moyad Jamal;Shaikh, Masood Ali;Shakerimoghaddam, Ali;Shakoor, Sadia;Sham, Sunder;Shamim, Muhammad Aaqib;Shams-Beyranvand, Mehran;Shamsi, Anas;Shamsutdinova, Alfiya;Shan, Dan;Shannawaz, Mohammed;Sharifan, Amin;Sharifi Rad, Javad;Sharma, Bunty;Sharma, Kamlesh;Sharma, Manoj;Sharma, Ravi Kumar;Sharma, Vishal;Shawahna, Ramzi;Shehata, Hatem Samir;Sheidaei, Ali;Shenoy, Suchitra M;Sherchan, Samendra P;Shetty, Mahabalesh;Shetty, Pavanchand H;Shetty, Premalatha K;Shimul, Md Monir Hossain;Shittu, Aminu;Shivarov, Velizar;Shokri, Azad;Shool, Sina;Shorofi, Seyed Afshin;Shuaibu, Suleiman Adeiza;Sibuyi, Nicole Remaliah Samantha;Siddig, Emmanuel Edwar;Silva, Luís Manuel Lopes Rodrigues;Simões, Eric A. 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2026

Abstract

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.

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	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-10/B - Malattie infettive
Settore MEDS-24/B - Igiene generale e applicata
			
	Data di pubblicazione
	
				2026
			
	Data ahead of print o data di stampa
	
				27-mar-2026
			
	Rivista in ANCE
	
				LANCET NEUROLOGY
			
	DOI
	
				https://dx.doi.org/10.1016/s1474-4422(26)00101-8
			
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1232017

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