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
Usha Adiga
Emad M. Abdallah
Dariush Abtahi
Meriem Abdoun
Eman Abu-Gharbieh
Anirudh Balakrishna Acharya
Mohd Adnan
Mitra Abbasifard
Victor Adekanmbi
Asrat Agalu Abejew
Oyelola A. Adegboye
Samar Abd ElHafeez
Jeza Muhamad Abdul Aziz
Muhammad Sohail Afzal
Nermeen Abu-Elala
Auwal Abdullahi
Khurshid Ahmad
Rana Kamal Abu Farha
Isaac Yeboah Addo
Ahmad Y. Abuhelwa
Nadin M.I. Abdel Razeq
Sherief Abd-Elsalam
Swetha Acharya
Williams Agyemang-Duah
Samir Abu Rumeileh
Lucien R. Swetschinski
Juliana Bunmi Adetunji
Lisa C. Adams
Fuad Hamdi A. Abuadas
Madineh Abbasi
Ali Ahmadi
Omar Ahmed Abdelwahab
Bright Opoku Ahinkorah
Nurudeen A. Adegoke
Ayman Ahmed
Negar Sadat Ahmadi
Rezheen Fatah Abdulrahman
Danish Ahmad
Meshack Achore
Olumide Thomas Adeleke
Olifan Zewdie Abil
Armita Abedi
Dina Abushanab
Sawsan Abuhammad
Mostafa M. Abdrabou
Eve E. Wool
David Adedia
Kamoru Ademola Adedokun
Muayyad M. Ahmad
Aqeel Ahmad
Qorinah Estiningtyas Sakilah Adnani
Miracle Ayomikun Adesina
Hedayat Abbastabar
Tauseef Ahmad
Avina Vongpradith
Mohammed Altigani Abdalla
Temitayo Esther Adeyeoluwa
Atman Adiba
Chieh Han
Sajjad Ahmad
Gasha Salih Ahmed
Aanuoluwapo Adeyimika Afolabi
Rose Grace Bender
Giuseppina Affinito
Sepehr Aghajanian
Richard Gyan Aboagye
Rahim Abo Kasem
Mohammad Amin Aalipour
Sarah Brooke Sirota
Rizwan Suliankatchi Abdulkader
Ahmed A.J. Jabbar
Ridwan Olamilekan Adesola
Arman Abdous
Nagah M. Abourashed
Toufik Abdul-Rahman
Prince Owusu Adoma
Gizachew Beykaso Agafari
Regina Mae Villanueva Dominguez
Hana J. Abukhadijah
Abdullahi Tunde Aborode
Ibrahim Banaru Abubakar
Mehrunnisha Sharif Ahmed
Sepideh Ahmadi
Amir Mahmoud Ahmadzade
Daniel T. Araki
Hassan Abolhassani
Aminu Kende Abubakar
Idowu Peter Adewumi
Faisal Ahmad
Syed Hani Abidi
Amanda Movo
Hasan Aalruz
Haroon Ahmed
Faezeh Abbaspour
Krishna Prasad Acharya
Suhaib Ahmad
Zhanar Abu
Abisola Esther Abdulmalik
Olumide Abiodun
Saira Afzal
Publication Name: Lancet Neurology
Publication Date: 2026-05-01
Volume: 25
Issue: 5
Page Range: 451-468
Description:
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.
Open Access: Yes
Authors - 100
Usha Adiga
14057674100
Emad M. Abdallah
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Dariush Abtahi
18036750600
Meriem Abdoun
20336514800
Eman Abu-Gharbieh
24586714800
Anirudh Balakrishna Acharya
35751874500
Mohd Adnan
36022136700
Mitra Abbasifard
37053407900
Victor Adekanmbi
53463192900
Asrat Agalu Abejew
55204820500
Oyelola A. Adegboye
55270465600
Samar Abd ElHafeez
55551273300
Jeza Muhamad Abdul Aziz
55670686800
Muhammad Sohail Afzal
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Nermeen Abu-Elala
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Auwal Abdullahi
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Khurshid Ahmad
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Rana Kamal Abu Farha
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Isaac Yeboah Addo
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Ahmad Y. Abuhelwa
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Nadin M.I. Abdel Razeq
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Sherief Abd-Elsalam
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Swetha Acharya
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Williams Agyemang-Duah
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Samir Abu Rumeileh
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Lucien R. Swetschinski
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Juliana Bunmi Adetunji
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Lisa C. Adams
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Fuad Hamdi A. Abuadas
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Madineh Abbasi
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Ali Ahmadi
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Omar Ahmed Abdelwahab
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Bright Opoku Ahinkorah
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Nurudeen A. Adegoke
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Ayman Ahmed
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Negar Sadat Ahmadi
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Rezheen Fatah Abdulrahman
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Danish Ahmad
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Meshack Achore
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Olumide Thomas Adeleke
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Olifan Zewdie Abil
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Armita Abedi
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Dina Abushanab
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Sawsan Abuhammad
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Mostafa M. Abdrabou
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Eve E. Wool
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David Adedia
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Kamoru Ademola Adedokun
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Muayyad M. Ahmad
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Aqeel Ahmad
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Qorinah Estiningtyas Sakilah Adnani
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Miracle Ayomikun Adesina
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Hedayat Abbastabar
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Tauseef Ahmad
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Avina Vongpradith
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Mohammed Altigani Abdalla
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Temitayo Esther Adeyeoluwa
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Atman Adiba
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Chieh Han
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Sajjad Ahmad
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Gasha Salih Ahmed
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Aanuoluwapo Adeyimika Afolabi
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Rose Grace Bender
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Giuseppina Affinito
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Sepehr Aghajanian
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Richard Gyan Aboagye
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Rahim Abo Kasem
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Mohammad Amin Aalipour
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Sarah Brooke Sirota
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Rizwan Suliankatchi Abdulkader
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Ahmed A.J. Jabbar
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Ridwan Olamilekan Adesola
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Arman Abdous
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Nagah M. Abourashed
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Toufik Abdul-Rahman
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Prince Owusu Adoma
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Gizachew Beykaso Agafari
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Regina Mae Villanueva Dominguez
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Hana J. Abukhadijah
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Abdullahi Tunde Aborode
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Ibrahim Banaru Abubakar
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Mehrunnisha Sharif Ahmed
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Sepideh Ahmadi
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Amir Mahmoud Ahmadzade
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Daniel T. Araki
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Hassan Abolhassani
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Aminu Kende Abubakar
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Idowu Peter Adewumi
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Faisal Ahmad
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Syed Hani Abidi
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Amanda Movo
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Hasan Aalruz
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Haroon Ahmed
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Faezeh Abbaspour
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Krishna Prasad Acharya
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Suhaib Ahmad
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Zhanar Abu
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Abisola Esther Abdulmalik
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Olumide Abiodun
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Saira Afzal
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