Research shows meningitis and neonatal sepsis are 2nd largest infectious killers of under-5s

21 Apr 2021
Research shows meningitis and neonatal sepsis are 2nd largest infectious killers of under-5s
  • Estimates for meningitis as a cause of death differ widely across global health models and may be underestimated.
  • Globally, meningitis and neonatal sepsis are the second-largest infectious killers of children under five, according to World Health Organization (WHO) estimates
  • Whilst deaths from measles and tetanus in children under five years of age are estimated to have decreased by 86% and 92%, respectively, between 1990 and 2017, deaths from meningitis decreased by just 51%
  • WHO estimates show meningitis and neonatal sepsis were responsible for more deaths in under-fives than malaria, measles, HIV and tetanus combined
  • Despite its burden, meningitis is seldom, if at all, mentioned in critical global and regional health documents
Leading infectious causes of death in children under 5 in 2017. Source: World Health Organization Disease Burden and Mortality Estimates. Child Causes of Death, 2000–2017​

Meningitis is not being prioritised appropriately, according to new research. Difficulties collecting accurate data on meningitis has led to the diseases being missed from key global and regional health plans, despite it being a leading killer of children. The research was published in the journal MicroorganismsA new global plan to defeat meningitis has been developed as a result, which will improve meningitis surveillance and data and drive action to help save lives.
Among preventable diseases, meningitis has one of the highest fatality rates and can cause devastating epidemics. It is a complex disease caused by a range of bacteria. When these bacteria enter the body, they can lead to swelling around the brain (meningitis) or affect the whole body (sepsis). Meningitis and sepsis can occur together, and in new-borns, it is almost impossible to distinguish between the two on the basis of symptoms.
As the causes and symptoms are often the same, this analysis argues that grouping meningitis and neonatal sepsis together will help policymakers and health workers prioritise appropriate responses. Using WHO data, this approach identified that meningitis and neonatal sepsis collectively were the second-largest infectious killer of children under five years.
Several vaccines are available to protect against the most common causes of meningitis.

Meningitis Research Foundation, working with the World Health Organization, Institute for Health Metrics and Evaluation, Johns Hopkins Bloomberg School of Public Health and the Universities of Bristol and Cambridge, analysed infectious diseases estimates from a range of sources in a bid to paint a clearer picture of the burden of meningitis.

“Understanding disease data has huge implications for saving lives as efforts and resources can be targeted effectively. This new research highlights how the complexities of recognising meningitis have led to difficulties determining its impact. Meningitis as a cause of death is likely being underestimated, and as a result, progress in defeating it is stalling.” - Linda Glennie, Director of Research at Meningitis Research Foundation and one of the paper’s authors

The research shows that estimates for meningitis vary much more than for other infectious diseases, making it difficult for policymakers to prioritise it for action. It also showed that while deaths from measles and tetanus in children under five decreased by 86% and 92% respectively between 1990 and 2017, meningitis deaths decreased by just 51%. The authors were surprised to find that despite its burden, meningitis is seldom, if at all, mentioned in key global and regional health documents.
Linda Glennie added, “There needs to be a dramatic shift in the way meningitis is viewed. Diseases such as HIV, tetanus and measles have global targets and coordinated action plans.  Meningitis needs these global efforts too. We are pleased that there is now a Global Plan to defeat meningitis and that our research will help to inform how progress is monitored in future.”

Babies and toddlers are at greatest risk of contracting deadly meningitis.

The research is a collaboration between Meningitis Research Foundation, academics and modellers across major health global health models.  Findings have already led to improvements in estimation methods which will help ensure that meningitis is appropriately prioritised. 
The paper will inform a new Global Roadmap to Defeat Meningitis approved by the World Health Assembly in November 2020 and due to be formally launched this year. For the first time, the roadmap will set targets and monitor the progress that will dramatically reduce deaths and disability from meningitis.

This research appears in a special issue of the scientific journal Microorganisms: "Bacterial Meningitis: Epidemiology and Vaccination". It includes the latest research to tackle the main causes of acute bacterial meningitis.
Defeating Meningitis by 2030: A Global Roadmap
Defeating Meningitis by 2030: A Global Roadmap
Cuts to research funding mean your support is needed more than ever to bring a world free from meningitis one step closer.
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