Impact of Introduction of the Haemophilus influenzae Type b Conjugate Vaccine into Childhood Immunization on Meningitis in Bangladeshi Infants

• Published in: The Journal of pediatrics Vol. 163; no. 1; pp. S73 - S78
• Main Authors: Sultana, Nadira K., MBBS, MPH, Saha, Samir K., PhD, Al-Emran, Hassan M., MSc, Modak, Joyanta K., MSc, Sharker, M. A. Yushuf, MPhil, El-Arifeen, Shams, MBBS, DrPH, Cohen, Adam L., MD, MPH, Baqui, Abdullah H., MBBS, DrPH, Luby, Stephen P., MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.07.2013
• Subjects: agglutination; Bangladesh - epidemiology; burden of disease; Child; childhood; children; Female; Haemophilus influenzae; Haemophilus Vaccines - administration & dosage; hospitals; Humans; Immunization Programs; Incidence; Infant; infants; latex; Male; meningitis; Meningitis, Bacterial - epidemiology; Meningitis, Bacterial - prevention & control; Meningitis, Haemophilus - epidemiology; Meningitis, Haemophilus - prevention & control; monitoring; Pediatrics; polymerase chain reaction; Streptococcus pneumoniae; uncertainty; vaccination; Vaccines, Conjugate - administration & dosage; watersheds; Bangladesh; Hib; Polymerase chain reaction; DTP; Latex agglutination test; CSF; Cerebrospinal fluid; Expanded Program on Immunization; Haemophilus influenzae type b; Diphtheria-tetanus-pertussis; LAT; PCR; EPI
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2013.03.033

Objectives Some Asian countries have been reluctant to adopt Haemophilus influenzae type b (Hib) conjugate vaccination because of uncertainty over disease burden. We assessed the impact of introduction of Hib conjugate vaccine into the Expanded Program on Immunization in Bangladesh on purulent and laboratory-confirmed H influenzae meningitis. Study design Within a well-defined catchment area around 2 surveillance hospitals in Dhaka, Bangladesh, we compared the incidence of Hib meningitis confirmed by culture, latex agglutination, and polymerase chain reaction assay among infants 1 year before and 1 year after introduction of Hib conjugate vaccine. We adjusted the incidence rate for the proportion of children who sought care at the surveillance hospitals. Results Among infants, the incidence of confirmed Hib meningitis decreased from 92-16 cases per 100 000 within 1 year of vaccine introduction (vaccine preventable incidence = 76; 95% CI 18, 135 per 100 000). The incidence of purulent meningitis decreased from 1659-1159 per 100 000 (vaccine preventable incidence = 500; 95% CI: 203, 799 per 100 000). During the same time period, there was no significant difference in the incidence of meningitis due to Streptococcus pneumoniae. Conclusions Introduction of conjugate Hib conjugate vaccine into Bangladesh Expanded Program on Immunization markedly reduced the burden of Hib and purulent meningitis.