CoChat
Sign Up
Cited by 116Bacterial Infections and VaccinesGlobal Health and SurgeryInfectious Encephalopathies and Encephalitis

The DOI matches its Crossref record; 190 of the 190 references it cites were found in a registry or an index.

Epidemiology of central nervous system infectious diseases: a meta-analysis and systematic review with implications for neurosurgeons worldwide

Robertson, Faith C., Lepard, Jacob R., Mekary, Rania A., Davis, Matthew C., Yunusa, Ismaeel, Gormley, William B., Baticulon, Ronnie E., Mahmud, Muhammad Raji, Misra, Basant K., Rattani, Abbas, Dewan, Michael C., Park, Kee B.·2019·Journal of Neurosurgery
DOI 10.3171/2017.10.jns17359
Open this paper in CoChat — free account

Abstract

OBJECTIVE: Central nervous system (CNS) infections cause significant morbidity and mortality and often require neurosurgical intervention for proper diagnosis and treatment. However, neither the international burden of CNS infection, nor the current capacity of the neurosurgical workforce to treat these diseases is well characterized. The objective of this study was to elucidate the global incidence of surgically relevant CNS infection, highlighting geographic areas for targeted improvement in neurosurgical capacity. METHODS: A systematic literature review and meta-analysis were performed to capture studies published between 1990 and 2016. PubMed, EMBASE, and Cochrane databases were searched using variations of terms relating to CNS infection and epidemiology (incidence, prevalence, burden, case fatality, etc.). To deliver a geographic breakdown of disease, results were pooled using the random-effects model and stratified by WHO region and national income status for the different CNS infection types. RESULTS: The search yielded 10,906 studies, 154 of which were used in the final qualitative analysis. A meta-analysis was performed to compute disease incidence by using data extracted from 71 of the 154 studies. The remaining 83 studies were excluded from the quantitative analysis because they did not report incidence. A total of 508,078 cases of CNS infections across all studies were included, with a total sample size of 130,681,681 individuals. Mean patient age was 35.8 years (range: newborn to 95 years), and the male/female ratio was 1:1.74. Among the 71 studies with incidence data, 39 were based in high-income countries, 25 in middle-income countries, and 7 in low-income countries. The pooled incidence of studied CNS infections was consistently highest in low-income countries, followed by middle- and then high-income countries. Regarding WHO regions, Africa had the highest pooled incidence of bacterial meningitis (65 cases/100,000 people), neurocysticercosis (650/100,000), and tuberculous spondylodiscitis (55/100,000), whereas Southeast Asia had the highest pooled incidence of intracranial abscess (49/100,000), and Europe had the highest pooled incidence of nontuberculous vertebral spondylodiscitis (5/100,000). Overall, few articles reported data on deaths associated with infection. The limited case fatality data revealed the highest case fatality for tuberculous meningitis/spondylodiscitis (21.1%) and the lowest for neurocysticercosis (5.5%). In all five disease categories, funnel plots assessing for publication bias were asymmetrical and suggested that the results may underestimate the incidence of disease. CONCLUSIONS: This systematic review and meta-analysis approximates the global incidence of neurosurgically relevant infectious diseases. These results underscore the disproportionate burden of CNS infections in the developing world, where there is a tremendous demand to provide training and resources for high-quality neurosurgical care.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3171/2017.10.jns17359

Cites

190 of 190 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 2

  1. Chapp-Jumbo EN: Neurologic admissions in the Niger delta area of Nigeria - a ten year review. Afr J Neurol Sci 23:77, 2004
  2. Goodman-Meza D, Ware JA, Anthony A, Coyle CM, Nash TE: Retrospective review of cysticercosis in returned United States travelers. Am J Trop Med Hyg 91 (5 Suppl 1):364, 2014 (Abstract)

Cited by

Sorted by citations

See all 116

Related

See all

Metadata

Authors
Robertson, F. C., Lepard, J. R., Mekary, R. A., Davis, M. C., Yunusa, I., Gormley, W. B., Baticulon, R. E., Mahmud, M. R., Misra, B. K., Rattani, A., Dewan, M. C., & Park, K. B.
Affiliations
  • Brigham and Women's Hospital (US)
  • University of Alabama at Birmingham (US)
  • Philippine General Hospital (PH)
  • National Hospital Abuja (NG)
  • P. D. Hinduja Hospital and Medical Research Centre (IN)
  • Meharry Medical College (US)
  • Harvard University (US)
ORCID
Venue
Journal of Neurosurgery
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Published
2019-04
Volume
130
Issue
4
Pages
1107-1126
ISSN
  • 0022-3085 (ISSN-L)
  • 1933-0693
DOI
10.3171/2017.10.jns17359
OpenAlex
W2808228286
Cited by
116
References
190
Citations by year
2026: 14 · 2025: 15 · 2024: 14 · 2023: 21 · 2022: 14 · 2021: 16 · 2020: 13 · 2019: 6
FWCI
1.35
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
Funders
  • Congress of Neurological Surgeons
  • Vanderbilt University
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
central nervous system infection, incidence, global burden of disease, neurosurgical workforce, bacterial meningitis, neurocysticercosis, tuberculous spondylodiscitis, intracranial abscess, case fatality, WHO regions, low-income countries, neurosurgical training

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review