Past, present and future of meningitis in Brazilian children and teenagers: a trend analysis from 2002 to 2022

*Correspondence: [e-mail].

Abstract

Background: Meningitis is a serious disease that affects the membranes that cover the central nervous system, causing inflammation. Typically, children and teenagers are more affected due to the immaturity of the blood-brain barrier and the immune system, which may result in prolonged permanent side effects or death.

Objective: To analyze the trend of incidence and mortality of meningitis in children and teenagers aged 0 to 19 years in Brazilian macro-regions, from 2002 to 2022.

Methods: This is an ecological study of time series carried out in Brazilian macro-regions with data from the Notifiable Health Conditions Information System (SINAN), from 2002 to 2022. Statistical analyzes were performed with the Joinpoint software, using the Monte Carlo permutation method and the logarithm of the ratio to estimate the Average Annual Percent Change (AAPC) of incidence and mortality.

Results: There were 274,500 cases of meningitis during the analyzed period, in which 59.8% were male and 52.7% were between 0 to 4 years old. Furthermore, there were 17,162 deaths, in which 56.8% were male. Meningococcemia was the etiology that presented the highest lethality rates, mainly in 2020. Regarding the incidence, the highest numbers were in the age group from 0 to 4 years in all macroregions, with the South having the highest average incidence and the North having the lowest values in all age groups. In mortality, the most affected age group was the same as the incidence and the Southeast Region presented the highest average rate. The trend of incidence (AAPC: -5.8, CI 95%: -7.2;-4.3) and mortality (AAPC: -8.5, CI 95%: -9.3; -7.6) are decreasing in Brazil as a result of the descending trends in all regions, with the incidence showing greater reductions of the AAPC in males, except in the Midwest Region, and, in terms of mortality, the North Region was the only one that showed greater reductions in the males. Finally, the projection of incidence and mortality rates were carried out over a period of 10 years, in which it is expected a reduction of 45% in the incidence and 62.3% in mortality rates in Brazil.

Conclusion: Meningitis has a decreasing trend in both incidence and mortality, but still has considerable values in Brazil, with younger and male children being more affected. Thus, improvements in disease prevention and control strategies are needed, especially in the most affected regions.

Publication History

Article published online:
12 May 2025