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
3
Issued Date
2026-01-01
Resource Type
ISSN
14744422
eISSN
14744465
Scopus ID
2-s2.0-105038249924
Pubmed ID
41911930
Journal Title
Lancet Neurology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lancet Neurology (2026)
Suggested Citation
Sirota S.B., Bender R.G., Dominguez R.M.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., Affinito G., Afolabi A.A., Afzal M.S., Afzal S., Agafari G.B., Aghajanian S., Agyemang-Duah W., Ahinkorah B.O., Ahmad A., Ahmad D., Ahmad F., Ahmad K., Ahmad M.M., Ahmad S., Ahmad S., Ahmad T., Ahmadi A., Ahmadi N.S., Ahmadi S., Ahmadzade A.M., Ahmed A., Ahmed G.S., Ahmed H., Ahmed M.S. 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. Lancet Neurology (2026). doi:10.1016/S1474-4422(26)00101-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116765
Title
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
Author(s)
Sirota S.B.
Bender R.G.
Dominguez R.M.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.
Affinito G.
Afolabi A.A.
Afzal M.S.
Afzal S.
Agafari G.B.
Aghajanian S.
Agyemang-Duah W.
Ahinkorah B.O.
Ahmad A.
Ahmad D.
Ahmad F.
Ahmad K.
Ahmad M.M.
Ahmad S.
Ahmad S.
Ahmad T.
Ahmadi A.
Ahmadi N.S.
Ahmadi S.
Ahmadzade A.M.
Ahmed A.
Ahmed G.S.
Ahmed H.
Ahmed M.S.
Bender R.G.
Dominguez R.M.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.
Affinito G.
Afolabi A.A.
Afzal M.S.
Afzal S.
Agafari G.B.
Aghajanian S.
Agyemang-Duah W.
Ahinkorah B.O.
Ahmad A.
Ahmad D.
Ahmad F.
Ahmad K.
Ahmad M.M.
Ahmad S.
Ahmad S.
Ahmad T.
Ahmadi A.
Ahmadi N.S.
Ahmadi S.
Ahmadzade A.M.
Ahmed A.
Ahmed G.S.
Ahmed H.
Ahmed M.S.
Author's Affiliation
Stanford University
The University of Sydney
Technische Universität München
UNSW Sydney
Karolinska Institutet
Yale School of Medicine
UCSF School of Medicine
Università degli Studi di Napoli Federico II
University at Buffalo, The State University of New York
University of Missouri
Queen’s University
Cairo University
University of Texas Health Science Center at Houston
Tehran University of Medical Sciences
University of Technology Sydney
Shahid Beheshti University of Medical Sciences
Martin-Luther-Universität Halle-Wittenberg
Alexandria University
Organisation Mondiale de la Santé
John Sealy School of Medicine
Tulane University
Iran University of Medical Sciences
University of Louisville School of Medicine
The University of Jordan
University of Ibadan
Mashhad University of Medical Sciences
Roswell Park Cancer Institute
University of Sharjah
Jordan University of Science and Technology
Qassim University
The University of Sydney School of Medicine
COMSATS University Islamabad
Universitas Padjadjaran
University of Canberra
Indian Council of Medical Research
School of Medicine
Jouf University
Ahmadu Bello University
Lebanese American University
University of Ha'il
Nazarbayev University
Hamad Medical Corporation
Bahir Dar University
Université Ferhat Abbas Sétif 1
Hofstra University
Applied Science Private University
Majmaah University
University of Management and Technology Lahore
Hull York Medical School
Faculty of Medicine
Bayero University
Menzies School of Health Research
JSS Academy of Higher Education & Research
Faculty of Veterinary Medicine
National Cancer Center Japan
Shaqra University
Zanjan University of Medical Sciences (ZUMS)
Islamic Azad University, Karaj Branch
Damascus University
Faculty of Medicine
School of Medicine and Psychology
Alborz University of Medical Sciences
Faculty of Science
Shahrekord University of Medical Sciences
Al-Zaytoonah University of Jordan
Zhejiang University School of Public Health
University of Health and Allied Sciences, Ghana
Rafsanjan University of Medical Sciences
University of Duhok
Institute for Health Metrics and Evaluation
Osun State University
Babcock University
Bowen University
Ambo University
Asfendiyarov Kazakh National Medical University
St. Luke’s International University
Research Center for Immunodeficiencies
Erbil Polytechnic University
University of Education, Winneba
Wachemo University
University of Medical Sciences
Hamad Bin Khalifa University, College of Health and Life Sciences
Abasyn University
Infectious and Tropical Diseases Research Center
University of Human Development
Komar University of Science and Technology
National Institute of Health Pakistan
Federal University, Wukari
Advanced Diagnostic and Interventional Radiology Research Center
Institute of Endemic Diseases Sudan
Bowen University Teaching Hospital
Apollo Institute of Medical Sciences & Research, Chittoor
Field of Veterinary Medicine
Healthy Africans Platform
Institute of Public Health
King Edward Memorial Hospital
Slum and Rural Health Initiative Research Academy
Technical Services Directorate
Sohail University
Baxshin Hospital
Toufik's World Medical Association
Pan-African One Health Institute (PAOHI)
Morocco
Health Policy
School of Surgery Wales
The University of Sydney
Technische Universität München
UNSW Sydney
Karolinska Institutet
Yale School of Medicine
UCSF School of Medicine
Università degli Studi di Napoli Federico II
University at Buffalo, The State University of New York
University of Missouri
Queen’s University
Cairo University
University of Texas Health Science Center at Houston
Tehran University of Medical Sciences
University of Technology Sydney
Shahid Beheshti University of Medical Sciences
Martin-Luther-Universität Halle-Wittenberg
Alexandria University
Organisation Mondiale de la Santé
John Sealy School of Medicine
Tulane University
Iran University of Medical Sciences
University of Louisville School of Medicine
The University of Jordan
University of Ibadan
Mashhad University of Medical Sciences
Roswell Park Cancer Institute
University of Sharjah
Jordan University of Science and Technology
Qassim University
The University of Sydney School of Medicine
COMSATS University Islamabad
Universitas Padjadjaran
University of Canberra
Indian Council of Medical Research
School of Medicine
Jouf University
Ahmadu Bello University
Lebanese American University
University of Ha'il
Nazarbayev University
Hamad Medical Corporation
Bahir Dar University
Université Ferhat Abbas Sétif 1
Hofstra University
Applied Science Private University
Majmaah University
University of Management and Technology Lahore
Hull York Medical School
Faculty of Medicine
Bayero University
Menzies School of Health Research
JSS Academy of Higher Education & Research
Faculty of Veterinary Medicine
National Cancer Center Japan
Shaqra University
Zanjan University of Medical Sciences (ZUMS)
Islamic Azad University, Karaj Branch
Damascus University
Faculty of Medicine
School of Medicine and Psychology
Alborz University of Medical Sciences
Faculty of Science
Shahrekord University of Medical Sciences
Al-Zaytoonah University of Jordan
Zhejiang University School of Public Health
University of Health and Allied Sciences, Ghana
Rafsanjan University of Medical Sciences
University of Duhok
Institute for Health Metrics and Evaluation
Osun State University
Babcock University
Bowen University
Ambo University
Asfendiyarov Kazakh National Medical University
St. Luke’s International University
Research Center for Immunodeficiencies
Erbil Polytechnic University
University of Education, Winneba
Wachemo University
University of Medical Sciences
Hamad Bin Khalifa University, College of Health and Life Sciences
Abasyn University
Infectious and Tropical Diseases Research Center
University of Human Development
Komar University of Science and Technology
National Institute of Health Pakistan
Federal University, Wukari
Advanced Diagnostic and Interventional Radiology Research Center
Institute of Endemic Diseases Sudan
Bowen University Teaching Hospital
Apollo Institute of Medical Sciences & Research, Chittoor
Field of Veterinary Medicine
Healthy Africans Platform
Institute of Public Health
King Edward Memorial Hospital
Slum and Rural Health Initiative Research Academy
Technical Services Directorate
Sohail University
Baxshin Hospital
Toufik's World Medical Association
Pan-African One Health Institute (PAOHI)
Morocco
Health Policy
School of Surgery Wales
Corresponding Author(s)
Other Contributor(s)
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.