WHO releases first-ever global guidelines on meningitis

Geneva: The World Health Organization (WHO) today introduced its first-ever global guidelines aimed at the diagnosis, treatment, and care of meningitis, intending to improve detection, facilitate timely treatment, and enhance long-term care for those affected by the illness. These guidelines incorporate the latest evidence-based recommendations, serving as a vital tool to help reduce the mortality and disability linked to the disease.

The disease is a threat to people of all ages and backgrounds, but its effects are particularly pronounced in low- and middle-income countries, as well as in regions experiencing significant outbreaks. The sub-Saharan African area, often referred to as the ‘meningitis belt,’ has the highest rates of the disease and is susceptible to recurring epidemics of meningococcal meningitis.

While effective treatments and vaccines are available for certain types of meningitis, the disease remains a significant global health issue. Bacterial meningitis, in particular, is the deadliest form, capable of leading to death within just 24 hours. In 2019, there were around 2.5 million reported cases of the disease globally, including 1.6 million bacterial cases that resulted in approximately 240,000 fatalities. Additionally, about 20% of those who survive bacterial meningitis experience long-term complications that can severely impact their quality of life. The disease also places considerable financial and social strains on individuals, families, and communities.

“Bacterial meningitis kills one in six of the people it strikes, and leaves many others with lasting health challenges,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Implementing these new guidelines will help save lives, improve long-term care for those affected by meningitis, and strengthen health systems.”

Best practices

Improving clinical management of the disease is essential to reducing mortality and morbidity, minimizing long-term complications and disability, and improving quality of life for affected individuals and communities.

The new guidelines provide evidence-based recommendations for the clinical management of children over one month of age, adolescents, and adults with acute community-acquired meningitis.

They address all aspects of clinical care, including diagnosis, antibiotic therapy, adjunctive treatment, supportive care, and management of long-term effects.  Given the similarities in clinical presentation, diagnosis, and management approaches across different forms of acute community-acquired meningitis, the guidelines address both bacterial and viral causes.

The guidelines provide recommendations for both non-epidemic and epidemic settings, the latter superseding the previous 2014 WHO guidelines, which covered meningitis outbreak response.

As resource-limited settings bear the highest burden of the disease, these guidelines have been specifically developed to provide technical guidance suitable for implementation in low- and middle-income countries.

The guidelines are intended for use by health-care professionals in first- and second-level facilities, including emergency, inpatient, and outpatient services. Policymakers, health planners, academic institutions, and civil society organizations can also use them to inform capacity-building, education, and research efforts.

Eradicating meningitis by 2030

The guidelines contribute to the broader Defeating Meningitis by 2030 Global Roadmap, adopted by WHO Member States in 2020, which aims to: eliminate bacterial meningitis epidemics, reduce cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70%, and reduce disability and improve quality of life after meningitis.

To reach these objectives, it is essential to implement coordinated efforts across five critical domains.

First, advancing diagnosis and treatment necessitates accelerating detection techniques and ensuring effective clinical management. Next, in the realm of prevention and epidemic control, the focus should be on creating affordable vaccines, achieving widespread immunization, and enhancing preparedness and response strategies for potential outbreaks. Additionally, improving disease surveillance is vital; this includes strengthening monitoring systems that inform prevention and control initiatives. Furthermore, it is crucial to offer care and support to those impacted by the disease, which entails facilitating early detection and enhancing access to care for individuals dealing with the disease’s lingering effects. Lastly, advocacy and engagement play a key role in fostering political commitment, incorporating the disease into national health strategies, increasing public awareness about the disease, and promoting the right to prevention, care, and aftercare services.

With these guidelines, WHO said it provides countries with a critical tool to close gaps in meningitis diagnosis, treatment and care, ensuring that more people receive timely treatment and long-term support.

– global bihari bureau