We used a rapid method from the World Health Organization to calculate the incidence of hospitalization for IPD (11). This method uses the sentinel hospital’s meningitis surveillance system to identify the numerator as potential bacterial meningitis cases and the denominator as the estimated number of children at risk for meningitis in the catchment area. China does not have a nationwide meningitis surveillance system, but SCH collects routine CSF, blood, and pleural fluid cultures from children with suspected IPD. We estimated the denominator (i.e., children at risk for IPD in the area) by multiplying the population <5 years of age in the catchment area by the percentage of children in that age group who are treated at SCH (67.7%). Thus, we calculated the incidence of hospitalization for IPD in the catchment area of SCH (Y) as (Figure 3)

Equation for the incidence of hospitalization for IPD in the catchment area of SCH.

We used the Wilson method for binominal distribution to estimate 95% CIs of IPD hospitalizations. We used the χ2 test to compare the incidence of hospitalization across different age groups. We conducted all statistical analyses using SAS version 9.4 (SAS Institute, https://www.sas.com).

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