{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:09:19Z","timestamp":1792382959022,"version":"4.4.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Encephalitis, an inflammatory central nervous system disease causing significant morbidity and mortality, disproportionately affects low- and middle-income countries (LMICs) due to healthcare disparities. Encephalitis has diverse etiologies\u2014viral, autoimmune, bacterial, parasitic\u2014each with distinct clinical and epidemiological features. Despite declining global age-standardized rates since 1990, inequities in diagnostics, vaccine coverage, and critical care persist, worsened by COVID-19 pandemic, which delayed diagnoses and disrupted vaccinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) across 204 countries (1990\u20132021). We used the Bayesian Age-Period-Cohort model with integrated nested Laplace approximation to predict encephalitis\u2019 future trends, through 2040, enhancing the study\u2019s predictive value. Sociodemographic Index (SDI) stratification and Bayesian meta-regression models assessed trends, with significance determined via 95% uncertainty intervals and estimated annual percentage change (EAPC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2021, 4.64 million individuals worldwide were affected by encephalitis (1.49 million new cases; 92,000 deaths), encompassing cases spanning acute, subacute, and chronic stages of the disease. Low-middle SDI regions bore 3\u20135 times higher burdens than high-SDI regions. South Asia had the highest burden (age-standardized prevalence rate [ASPR]: 140.9\/100,000; incidence [ASIR]: 51.3\/100,000), while Australasia reported the lowest (ASPR: 1.94\/100,000). High-SDI countries showed distinct patterns, such as rising incidence in Australia. COVID-19 was associated with an 18% increase in DALYs in high-burden regions. National disparities were stark: Pakistan, India, and Nepal had the highest burdens; Canada, the lowest. The encephalitis burden was greater in children than in other age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This analysis advances prior GBD research by integrating post-COVID-19 insights and future burden forecasts, filling pre-pandemic study gaps. GBD dataset does not differentiate etiological subtypes, limiting our analysis granularity given encephalitis\u2019 clinical and epidemiological heterogeneity. Socioeconomic inequities drive encephalitis burden, necessitating targeted interventions: scaling Japanese encephalitis vaccination in South Asia, strengthening African diagnostic hubs, and integrating climate-resilient surveillance. Post-pandemic recovery must prioritize healthcare infrastructure, telehealth, and policies addressing poverty and education. Global collaboration is critical to mitigate disparities and optimize region-specific strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1651734","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:31:30Z","timestamp":1758173490000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Socioeconomic drivers of encephalitis burden in the post-COVID era: a 204-country analysis from global burden of disease study 2021"],"prefix":"10.3389","volume":"13","author":[{"given":"Yikang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilong","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2377","DOI":"10.1093\/cid\/ciz635","article-title":"Clinical epidemiology, risk factors, and outcomes of encephalitis in older 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