JMIR Publications

ABSTRACT

Background:

Streptococcus Pneumoniae (Spn) has been a leading cause of bacterial meningitis in children. The most recent estimation on the global burden of Spn meningitis reports a positive trajectory in eliminating Spn through implementing pneumococcal conjugate vaccines (PCV). However, continuous monitoring and assessment of the disease burden is necessary due to the evidence of serotype replacement, antibiotic resistance, and impact of the recent coronavirus disease 2019 (COVID-19) pandemic.

Objective:

Therefore, the aim of this systematic review is to provide an updated and a focused assessment of the global and regional burden of Spn meningitis in children which can guide policies and strategies to reduce the disease burden.

Methods:

Population-based studies from 01 Jan 2000 to 01 Jan 2022 from electronic databases PubMed, Embase, Global Health (CABI), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus has been searched without any language restrictions. Studies were included if they reported incidence, prevalence, mortality, or case-fatality-ratio (CFR) for Spn meningitis for children age 0-4, if meningitis was confirmed by cerebrospinal fluid culture, the study period was minimum of one year, the number of reported case was at least 10, and contained no methodological ambiguities. Study characteristics including study period, setting, World Health Organization (WHO) region, income level, vaccination information, and participant data including age, number of cases, deaths, sequelae, and risk factors will be extracted from included studies. Generalised linear mixed models (GLMMs) meta-analysis will be performed to estimate pooled incidence and case-fatality-ratio (CFR). We will further assess risk of bias, heterogeneity, and perform subgroup and sensitivity analysis to provide meaningful interpretation of the current burden and literature for pneumococcal meningitis.

Results:

Our preliminary search rendered 9295 articles. Out of 275 studies that were assessed with our eligibility criteria, 117 articles were included. This screening process was demonstrated in a PRISMA flow chart. The results from the full study will be demonstrated through tables and figures giving insight regarding incidence, CFR, and risk factors related to the burden of Spn meningitis.

Conclusions:

Given that the major burden of Spn meningitis affects children under the age of five, this systematic review will provide a thorough understanding of the global burden of Spn meningitis in this vulnerable population over a span of two decades. Insights into incidence trends, geospatial distribution, risk factors, and sequelae will be valuable for stakeholders, policymakers, and the academic community. This information will aid in ongoing monitoring of the disease and in enhancing targeted vaccine programmes to further mitigate the impact of the disease on children worldwide.