Abstract
BACKGROUND: Childhood meningitis remains a serious and life-threatening infectious disease with considerable risk of long-term sequelae. This study aimed to provide a comprehensive evaluation of the global burden and temporal trends of childhood meningitis from 1990 to 2021. METHODS: We extracted data from the Global Burden of Disease (GBD) Study 2021 to estimate incident cases, incidence rates, deaths, and mortality rates of childhood meningitis at global, regional, and national levels. We further assessed the etiological composition of childhood meningitis across different age groups and sociodemographic index (SDI) regions. Additionally, cross-country inequality analyses were conducted to measure the distributional inequality of childhood meningitis burden across countries. RESULTS: In 2021, childhood meningitis accounted for approximately 1.33 million incident cases and 112,000 deaths worldwide. The global incidence rate of childhood meningitis decreased by 59.8%, from 164.80 per 100,000 in 1990 to 66.24 per 100,000 in 2021. The global mortality rate also decreased by 69.18%, from 18.12 per 100,000 in 1990 to 5.59 per 100,000 in 2021. In 2021, the top three etiologies responsible for global childhood meningitis deaths were Streptococcus pneumoniae (17.01%), Neisseria meningitidis (14.03%), and Klebsiella pneumoniae (12.11%). Notably, the leading etiologies of neonatal meningitis deaths were Group B Streptococcus (22.70%), Klebsiella pneumoniae (16.97%), and viral etiologies (15.35%). Cross-country inequality analysis revealed that low SDI regions bore a disproportionate burden. CONCLUSIONS: Despite significant progress over the past three decades, childhood meningitis remains a major public health challenge, particularly in resource-limited settings. Concerted efforts are required to reduce the unacceptable health inequities associated with this devastating disease.