ArticleEClinicalMedicine2019
Consistent, Excess Viral Meningitis Incidence Rates in Young Males: A Multi-country, Multi-year, Meta-analysis of National Data. The Importance of Sex as a Biological Variable.
Article in EClinicalMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Gender differences in tuberculosis incidence rates-A pooled analysis of data from seven high-income countries by age group and time period.Frontiers in public health · 2022Pooled it
- A meta-analytic evaluation of sex differences in meningococcal disease incidence rates in 10 countries.Epidemiology and infection · 2020Pooled it
- Sex differences in campylobacteriosis incidence rates at different ages - a seven country, multi-year, meta-analysis. A potential mechanism for the infection.BMC infectious diseases · 2020Pooled it
- A multi-country, multi-year, meta-analytic evaluation of the sex differences in age-specific pertussis incidence rates.PloS one · 2020Pooled it
- Changing Etiological Patterns of Pediatric Meningitis: A Three-Year Experience from a Tertiary Pediatric Emergency Hospital in Romania.Medicina (Kaunas, Lithuania) · 2026Article
- Fatal inflammation: understanding meningitis mortality in the United States (1999-2020).BMC neurology · 2026Observational
- The Meningitis and Encephalitis Registry of Lower Saxony, Germany (MERIN) - design and main results of circulating neurotropic pathogen surveillance, 2003 to 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- The global threat of vaccine-preventable neurological diseases.Nature reviews. Neurology · 2026Review
- Sex differences in acute respiratory tract infections-multi-year analysis based on data from a large tertiary care medical center in Israel.Frontiers in public health · 2025Article
- The burden of infective encephalitis in children in Asian countries (1990-2021): systematic analysis and projection of the burden of disease.Frontiers in cellular and infection microbiology · 2025Article
- Sex differences in hepatitis A incidence rates-a multi-year pooled-analysis based on national data from nine high-income countries.PloS one · 2023Article
- Article
- Gender differences in measles incidence rates in a multi-year, pooled analysis, based on national data from seven high income countries.BMC infectious diseases · 2022Article
- A Pooled Analysis of Sex Differences in Rotaviral Enteritis Incidence Rates in Three Countries Over Different Time Periods.Women's health reports (New Rochelle, N.Y.) · 2022Article
- The epidemiological profile of meningitis among adults in a South African district hospital.The Pan African medical journal · 2022Observational
- A systematic literature review on the prevalence and etiology of meningitis among critically ill and hospitalized patients in India.Therapeutic advances in infectious diseaseReview
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3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSex can be an important biological variable in the immune response to infections and the response to vaccines. The magnitude and consistency in age-specific sex differences in the incidence of viral infections remain unclear.
methodsWe obtained data from national official agencies on cases of viral meningitis by sex and age group over a period of 6-16 years from five countries: Canada, Czech Republic, Germany, Israel, and Poland. Male to female incidence rate ratios (RR) were computed for each year, by country, and age group. For each age group, we used meta-analysis methodology to combine the incidence RRs. Meta-regression was conducted to the estimate the effects of age, country, and time period on the RR.
findingsIn the age groups < 1, 1-4, 5-9, 10-14, there were consistently higher incidence rates in males, over countries and time. The pooled incidence RRs (with 95% CI) were 1.38 (1.30-1.47), 1.94 (1.85-2.03), 1.98 (1.88-2.07), and 1.58 (1.47-1.71) respectively. In young and middle-age adults there were no differences with pooled incidence RRs of 1.00 (0.97-1.03), and 0.97 (0.94-1.00), respectively. Sensitivity analysis confirms that the results are stable and robust. Meta-regression showed that almost all the variations in the incidence RRs were contributed by age group.
interpretationThe higher incidence rates from viral meningitis in males under the age of 15 are remarkably consistent across countries and time-periods. These findings emphasize the importance of sex as a biological variable in infectious diseases. This could provide keys to the mechanisms of infection and lead to more personalized treatment and vaccine doses and schedules.
fundingThere was no funding source for this article.
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