The findings come from the latest Global Burden of Disease Study 2023, published in The Lancet Neurology. The study offers the most comprehensive assessment to date, examining 17 different pathogens alongside key environmental and health-related risk factors driving meningitis infections and mortality across regions.
Slowing Progress and Uneven Gains
While global efforts since 1990 have significantly reduced both the incidence and mortality of meningitis—particularly bacterial forms—progress has slowed markedly since 2015. This slowdown puts global targets, including those set by the World Health Organization for 2030, at risk.
The burden remains especially high in parts of sub-Saharan Africa, often referred to as the “meningitis belt,” where outbreaks are more frequent and healthcare access is limited. These disparities highlight the urgent need for stronger surveillance systems and improved early detection, particularly in high-risk regions.
Vaccination Gaps and Preventable Deaths
One of the most concerning findings is that nearly 100,000 deaths in 2023 were linked to pathogens that are preventable through existing vaccines. This points to significant gaps in vaccine access, uptake, and public awareness.
Experts emphasize that infection prevention and control (IPC) professionals play a critical role in bridging this gap. By integrating vaccination checks into routine healthcare visits and addressing vaccine hesitancy through community engagement, they can help improve coverage and protect vulnerable populations.
Emerging Threats Beyond Bacterial Meningitis
The study also signals a shift in the meningitis landscape. While bacterial causes have declined in some regions, viral and fungal pathogens are becoming increasingly important contributors to disease burden.
For example, non-polio enteroviruses are emerging as significant viral causes, yet global surveillance systems for these pathogens remain limited. Regional initiatives like the European Non-Polio Enterovirus Network and Asia-Pacific Network for Enterovirus Surveillance demonstrate how coordinated monitoring can improve early detection and response.
Fungal infections, such as those caused by Candida species, present additional challenges, particularly in hospital settings where infection control measures must be strengthened to prevent transmission.
Protecting the Most Vulnerable
Children under five years old continue to bear the greatest burden of meningitis. In community settings, their developing immune systems and behaviors—such as frequent hand-to-mouth contact—make them especially susceptible to infection.
In hospitals, newborns face heightened risks from pathogens like Group B streptococcus (GBS), which is a leading cause of neonatal meningitis. With no widely available vaccine yet, prevention relies on maternal screening and timely antibiotic administration during childbirth—strategies that are not always feasible in low-resource settings.
Addressing Broader Risk Factors
Beyond pathogens, the study highlights the role of broader health and environmental factors in meningitis risk. Low birth weight and household air pollution were identified as significant contributors, particularly in low- and middle-income countries.
Experts stress that tackling these risks requires integrated public health approaches. This includes promoting maternal health through proper nutrition and antenatal care, as well as advocating for cleaner household air to reduce children’s vulnerability to infections.
A Call for Renewed Action
Overall, the findings underscore that while progress has been made, it is fragile and uneven. Strengthening surveillance, expanding vaccination coverage, improving diagnostics, and addressing social determinants of health will be essential to reducing the global burden of meningitis.
As researchers including Hmwe Hmwe Kyu and Sarah Brooke Sirota emphasize, achieving global targets will require coordinated action across health systems, communities, and international organizations—particularly to protect the youngest and most vulnerable populations.