[Incidence of Haemophilus influenzae type b meningitis in children under 5 years from Malopolska region in the years 2003-2004--prospective study]. / Zapadalnosc na bakteryjne zapalenie opon mózgowo-rdzeniowych wywolane przez Haemophilus influenzae typu b, u dzieci w wieku do 5 lat, na terenie województwa malopolskiego w latach 2003-2004--badanie prospektywne.

ABSTRACT

AIM: the aim of the study was to establish the incidence of Haemophilus influenzae type b, Hib meningitis in the Malopolska province and to draw attention to the potential need for changing the rules of prophylaxis. MATERIAL AND METHODS: a prospective study was carried out among children from the Malopolska province under 5 years with meningitis who were hospitalized between 1 January 2003 and 31 December 2004. All paediatric and infectious diseases wards in 24 hospitals participated in the study. Diagnosis of Hib meningitis was based on symptoms of central nervous system inflammation together with (1) positive culture of Hib from cerebrospinal fluid and/or blood and/or (2) positive latex test identifying Hib in cerebrospinal fluid and/or blood and/or (3) detection of nucleic acid of Hib in cerebrospinal fluid and/or blood. RESULTS: in the studied period 27 cases of H. influenzae meningitis were observed (26 of type b and one case of type f). The incidence of Hib meningitis was as follows 6.4/100000 children under 5 years, 7.4/100000 children under 4 years and 13.2/100000 children under 2 years. One 3.5-year-old girl died. CONCLUSIONS: the study shows a high incidence of Hib meningitis, similar to that in the neighboring EU countries before implementation of wide preventive measures. Cases of suspected vaccination failure should be carefully verified, with specific methods since the number of failures has been shown to be overrated.