Dose-specific efficacy of Haemophilus influenzae type b conjugate vaccines: a systematic review and meta-analysis of controlled clinical trials.

Global coverage of infant Haemophilus influenzae type b (Hib) vaccination has increased considerably during the past decade, partly due to GAVI Alliance donations of the vaccine to low-income countries. In settings where large numbers of children receive only one or two vaccine doses rather than the recommended three doses, dose-specific efficacy estimates are needed to predict impact. The objective of this meta-analysis is to determine Hib vaccine efficacy against different clinical outcomes after receiving one, two or three doses of vaccine. Studies were eligible for inclusion if a prospective, controlled design had been used to evaluate commercially available Hib conjugate vaccines. Eight studies were included. Pooled vaccine efficacies against invasive Hib disease after one, two or three doses of vaccine were 59%, 92% and 93%, respectively. The meta-analysis provides robust estimates for use in decision-analytical models designed to predict the impact of Hib vaccine.

Seroprevalence of avian influenza A/H5N1 among poultry farmers in rural Indonesia, 2007.

Since 2003, about a third (> 150 cases) of human cases of highly pathogenic avian influenza (HPAI) A/H5N1 worldwide are reported from Indonesia. We measured the seroprevalence of H5N1 among Indonesian poultry farmers and assessed the risk factors for and knowledge of H5N1 infection. In 2007, poultry workers and farm residents were interviewed about risk factors for knowledge of and then examined for the seropositivity of H5N1 virus. Four hundred ninety-five of 622 farmers (80%) from 12 farms participated in the study. Of these, 71% were male, with a median age of 29 years. None tested positive for H5N1 virus. Masks were never worn by 54% of participants; 86% were afraid of becoming infected. For the preceding six months, 1 farm was confirmed as having poultry infected with H5N1 virus. No evidence of subclinical infection with avian influenza A/H5N1 virus was found among poultry farmers, although exposure of the farmers to this virus may have been limited. However, we recommend sustaining ongoing surveillance and control efforts.