Spatial and Temporal Analysis of Meningitis Cumulative  Incidence in Iran, 2011-2022

Maryam  Ghalandari; Ali  Dehghani; Seyed Mohsen  Zahraei; Mohammad Hassan  Lotfi; Farzan  Madadizadeh

doi:10.18502/ijph.v54i11.20395

Maryam Ghalandari Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Ali Dehghani Department of Biostatistics and Epidemiology, School of Public Health, Social Determinants of Health Research Center, Sha-hid Sadoughi University of Medical Sciences, Yazd, Iran
Seyed Mohsen Zahraei Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
Mohammad Hassan Lotfi Department of Biostatistics and Epidemiology, School of Public Health, Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Farzan Madadizadeh Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ijph.v54i11.20395

Keywords: Incidence; Meningitis; Bacterial; Haemophilus; Viral; Spatio-temporal analysis; Iran

Abstract

Background: Meningitis is a public health challenge and one of the plans of the WHO is to defeat meningitis by 2030. This study was conducted to determine the trend of cumulative incidence and to draw a geographic map of meningitis in Iran.

Methods: Data on the cases of Fever and Neurological Symptoms Syndrome was obtained from the national surveillance system from 2011 to 2022. The cumulative incidence of meningitis was calculated for each year. Joinpoint version 5.4.0 and ArcGIS Desktop (ArcMap) 10.8.2 were used to investigate the trend of the disease incidence and identify the high-risk areas, respectively.

Results: Overall, 18,500 (24.35%) of the total cases were reported as confirmed and probable cases of meningitis. The cumulative incidence of bacterial meningitis decreased significantly in all age groups (P<0.05). The incidence of viral meningitis decreased in all ages and the population under 5 years (P<0.05). The incidence of Hib meningitis decreased in the population under 5 yr from 2015-2019 (P<0.05). The incidence of meningitis from all forms decreased in all ages and populations under 5 yr but increased in the population over 5 yr from 2011 to 2019, though these changes were not statistically significant.

Conclusion: The incidence of bacterial and viral meningitis has decreased in Iran similar to most parts of the world. The decrease in the incidence of Hib meningitis after the implementation of the vaccination in children under 5 yr emphasizes the importance of continuing Hib vaccination and integrating pneumococcal and meningococcal vaccinations into the national vaccination program.