Action for child survival: elimination of Haemophilus influenzae type b meningitis in Uganda.
Bull World Health Organ
; 86(4): 292-301, 2008 Apr.
Article
em En
| MEDLINE
| ID: mdl-18438518
ABSTRACT
OBJECTIVE:
To guide immunization policy, we determined the public health benefit of introducing Haemophilus influenzae type b (Hib) vaccine in Uganda and estimated the vaccine effectiveness.METHODS:
Surveillance data for acute bacterial meningitis among children aged 0-59 months were reviewed from three hospital sentinel sites, for July 2001 to June 2007, to determine the incidence of Hib meningitis, the effectiveness of Hib vaccine with a case-control design, and the number of vaccine-preventable cases and deaths of Hib disease in Uganda.FINDINGS:
Of the 13 978 children from 17 districts with suspected bacterial meningitis, 269 had confirmed Hib meningitis, declining from 69 patients in the prevaccine year (2001-2002) to three in 2006-2007. Hib meningitis incidence dropped from 88 cases per 100,000 children aged < 5 years in the year before vaccine introduction to 13 within 4 years, and to near zero in the fifth year. Vaccine effectiveness for 2 or more doses was 93% (95% confidence interval, CI 69-99) against confirmed Hib meningitis and 53% (95% CI 11-68) against purulent meningitis of unknown cause. In Uganda, Hib vaccine prevents an estimated 28 000 cases of pneumonia and meningitis, 5000 deaths and 1000 severe meningitis sequelae each year.CONCLUSION:
Infant immunization with Hib vaccine has virtually eliminated Hib meningitis in Uganda within 5 years. Ensuring long-term benefits of Hib vaccine urgently requires sustainable vaccine financing, high-quality ongoing surveillance, and a health sector able to deliver a robust immunization programme.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cápsulas Bacterianas
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Vacinas Anti-Haemophilus
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Haemophilus influenzae tipo b
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Meningite por Haemophilus
Tipo de estudo:
Screening_studies
Limite:
Child, preschool
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Humans
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Infant
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Newborn
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article