Age-period-cohort analysis of meningitis incidence and mortality trends among Chinese residents from 1990 to 2021

ObjectiveTo understand the trends in meningitis incidence and mortality among Chinese residents from 1990 to 2021, and to provide a reference for the development of relevant prevention and control policies and measures for meningitis in China. MethodsData on meningitis incidence and mortality among Chinese residents from 1990 to 2021 were collected from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analyses were conducted using indicators such as the number of cases, incidence rate, age-standardized incidence rate (ASIR), number of deaths, mortality rate, and age-standardized mortality rate (ASDR). Joinpoint regression models were used to analyze the trends in incidence and mortality rates of meningitis among Chinese residents and to calculate the average annual percentage change (AAPC). Age-period-cohort (APC) models were used to fit and estimate the age, period, and cohort effects on the risk of meningitis incidence and mortality among Chinese residents. ResultsThe incidence rate of meningitis among the total population, male residents, and female residents in China decreased from 28.34/100 000, 31.66/100 000, and 24.81/100 000 in 1990 to 4.82/100 000, 5.84/100 000, and 3.75/100 000 in 2021,respectively. The ASIR decreased from 30.83/100 000, 34.48/100 000, and 27.20/100 000 in 1990 to 5.79/100 000, 7.16/100 000, and 4.42/100 000 in 2021, respectively. The AAPC values for ASIR were –5.30%, –4.96%, and –5.71% (all P<0.001), respectively. The mortality rate of meningitis among the total population, male residents, and female residents in China decreased from 3.17/100 000, 3.60/100 000, and 2.71/100 000 in 1990 to 0.43/100 000, 0.50/100 000, and 0.36/100 000 in 2021, respectively. The ASDR decreased from 3.54/100 000, 4.02/100 000, and 3.06/100 000 in 1990 to 0.48/100 000, 0.58/100 000, and 0.38/100 000 in 2021, respectively. The AAPC values for ASDR were –6.31%, –6.11%, and –6.56% (all P<0.001), respectively. The APC model analysis showed that the age effects of both meningitis incidence and mortality initially decreased and then increased with age. The age effect coefficients for meningitis incidence among the total population, male residents, and female residents in China decreased from 1.945, 1.857, and 2.065 for ages 0–4 to –1.194, –1.112, and –1.381 for ages 45–49, and then increased to 1.874, 2.087, and 1.905 for ages 90–94, respectively. The age effect coefficients for meningitis mortality among the total population and male residents decreased from 2.425 and 2.386 for ages 0–4 to –1.279 and –1.381 for ages 25–29, and then increased to 2.116 and 2.371 for ages 90–94, respectively. The age effect coefficients for meningitis mortality among female residents decreased from 2.466 for ages 0–4 to –1.329 for ages 30–34, and then increased to 2.086 for ages 90–94. Both the period effects of meningitis incidence and mortality showed a decreasing trend. The period effect coefficients for meningitis incidence and mortality among the total population, male residents, and female residents in China decreased from 0.583 and 0.671, 0.555 and 0.652, and 0.612 and 0.686 for the period 1992–1996 to –0.362 and –0.368, –0.291 and –0.339, and –0.463 and –0.404 for the period 2017–2021, respectively. Both the cohort effects of meningitis incidence and mortality showed a fluctuating downward trend. The cohort effect coefficients for meningitis incidence and mortality among the total population, male residents, and female residents in China decreased from 0.094 and 0.150, 0.207 and 0.214, and –0.025 and 0.115 for the cohort 1902–1906 to –1.037 and –1.461, –1.097 and –1.537, and –1.002 and –1.401 for the cohort 2017–2021, respectively. ConclusionThe incidence and mortality rates of meningitis among Chinese residents showed an overall downward trend from 1990 to 2021. However, it is still necessary to strengthen the prevention and control of meningitis among residents in younger and older age groups.