Trends in incidence, mortality, and lethality due to meningitis in children and teenagers in Brazil: a nationwide time-series study from 2002 to 2022.

Abstract

Objective: The aim of this study was to analyze the trends in incidence, mortality, and lethality rates due to meningitis in children and teenagers aged 0-19 years in Brazil and its regions by sex from 2002 to 2022.

Methods: This is a time-series study of the cases and deaths due to meningitis with data from the Notifiable Diseases Information System. We estimated the average annual percent change (AAPC) and its 95% confidence interval (95%CI) via Joinpoint regression, in addition to comparing the Brazilian Federative Units' AAPCs by a pairwise coincidence test.

Results: There were 274,500 cases and 17,162 deaths during the analyzed period, with downward trends both in Brazil and its regions regarding the incidence and mortality rates. In Brazil, the lowest AAPC in incidence was among males (AAPC=-5.7, 95%CI -7.1 to -4.2), whereas the lowest AAPC in mortality was among females (AAPC=-8.2, 95%CI -9.1 to -7.3). There were greater reductions in the incidence among males in all regions, except for the Central-West. Regarding the mortality rate, Northeast (AAPC=-9.6, 95%CI -10.6 to -8.5), South (AAPC=-8.1, 95%CI -9.8 to -6.3), and Central-West (AAPC=-8.5, 95%CI -10.7 to -6.3) showed their lowest AAPCs among females. There were significant differences in trends between males and females, mostly regarding incidence rates.

Conclusion: Meningitis remains a concerning disease in Brazil, despite the downward trend in the country and its regions. It highlights the perpetuation of health inequalities, which reverberate in the levels of vaccination coverage and in the success of vaccination campaigns, impeding this disease's proper control.