The Global Burden of Meningitis in Children: Challenges with Interpreting Global Health Estimates.

Claire Wright,Vinny Smith,Han Yong Wunrow,Brian Wahl,Li Liu,James M Stuart,Rose Bender,Caroline Trotter,Linda Glennie,Maria Deloria Knoll,Hmwe Kyu,Diana Yeung,Natacha Blake

doi:10.3390/microorganisms9020377

Abstract

The World Health Organization (WHO) has developed a global roadmap to defeat meningitis by 2030. To advocate for and track progress of the roadmap, the burden of meningitis as a syndrome and by pathogen must be accurately defined. Three major global health models estimating meningitis mortality as a syndrome and/or by causative pathogen were identified and compared for the baseline year 2015. Two models, (1) the WHO and the Johns Hopkins Bloomberg School of Public Health’s Maternal and Child Epidemiology Estimation (MCEE) group’s Child Mortality Estimation (WHO-MCEE) and (2) the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease Study (GBD 2017), identified meningitis, encephalitis and neonatal sepsis, collectively, to be the second and third largest infectious killers of children under five years, respectively. Global meningitis/encephalitis and neonatal sepsis mortality estimates differed more substantially between models than mortality estimates for selected infectious causes of death and all causes of death combined. Estimates at national level and by pathogen also differed markedly between models. Aligning modelled estimates with additional data sources, such as national or sentinel surveillance, could more accurately define the global burden of meningitis and help track progress against the WHO roadmap.

Highlights

Licensee MDPI, Basel, Switzerland.The world saw great progress in reducing child mortality over the lifetime of the United Nations (UN) Millennium Development Goals (MDGs) with an estimated 54%decline in children under five years of age from 93 deaths per 1000 live births in 1990 to 43 per 1000 live births in 2015 [1]
Whilst deaths from measles and tetanus in children under five years are estimated to have decreased by 86% and 92% respectively, between 1990 and 2017, over the same time period deaths from meningitis are estimated to have decreased by just 51% [3]
Through attending key stakeholder meetings, we identified three modelling efforts that estimate the global burden of meningitis and neonatal sepsis: (1) World Health Organization (WHO) and the

Summary

Introduction

Decline in children under five years of age from 93 deaths per 1000 live births in 1990 to 43 per 1000 live births in 2015 [1]. With the majority of an estimated 38 deaths per 1000 live births in 2019 being caused by preventable and treatable diseases [1], we are a long way from achieving this target. Among these preventable diseases, meningitis has one of the highest fatality rates and the potential to cause devastating epidemics. Whilst deaths from measles and tetanus in children under five years are estimated to have decreased by 86% and 92% respectively, between 1990 and 2017, over the same time period deaths from meningitis are estimated to have decreased by just 51% [3]

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