Bacterial meningitis is a severe infectious condition with high potential for lethality and neurological sequelae, especially in children and the elderly. In Brazil, public immunization policies have been fundamental for preventing this disease, particularly with the progressive introduction of conjugate vaccines in the National Immunization Program (PNI). This study aims to describe trends in hospitalizations and lethality due to bacterial meningitis in the country between 2005 and 2024, in relation to expanded vaccination coverage and changes in the epidemiological profile of the disease. This is an ecological time-series study using secondary data from the Hospital Information System of the SUS (SIH/SUS) and the Notifiable Diseases Information System (SINAN). Hospitalizations for bacterial meningitis (ICD-10 G00.0 to G00.9) from 2005 to 2024 were included. Data were stratified by year, age group, geographic region and outcome (discharge or death). Hospitalization rates per 100,000 inhabitants and hospital lethality were calculated for each stratum. Descriptive analysis and comparisons between pre- and post-vaccination periods were performed. A total of 120,837 hospitalizations for bacterial meningitis were recorded between 2005 and 2024, 34% in children under 5 years of age. The hospitalization rate decreased from 10.4/100,000 inhabitants in 2005 to 4.1/100,000 in 2024, especially after the introduction of pneumococcal and meningococcal C vaccines in 2010. Overall lethality decreased from 18% to 11.2% in the period. Neonatal lethality remained high (mean 26.5%), and the elderly population showed a trend toward increasing cases with a mean lethality of 22%. The North and Northeast regions had the highest hospitalization and mortality rates in the last five years. Vaccines in Brazil have reduced hospitalizations and deaths from bacterial meningitis in young children; however, neonates and older adults still present high lethality. In addition, regional inequalities in access and vaccination coverage require more equitable actions. Therefore, investing in vaccination, surveillance and improved hospital care is essential to sustain progress.
Machado et al. (Sun,) studied this question.