The impact of routine infant immunization with Haemophilus influenzae type b conjugate vaccine in Malawi, a country with high human immunodeficiency virus prevalence.

Abstract

Malawi has extreme poverty and a high-human immunodeficiency virus (HIV) prevalence. Following Haemophilus influenzae type b (Hib) conjugate vaccine introduction during 2002, we evaluated vaccine impact by reviewing hospital surveillance data for acute bacterial meningitis in Blantyre district among children age 1-59 months admitted during 1997-2005. Documented annual Hib meningitis incidence rates decreased from 20-40/100,000 to near zero among both rural and urban residents despite no change in pneumococcal meningitis incidence rates. Before vaccine introduction, an average of 10 children/year had Hib meningitis and HIV infection compared to 2/year during 2003-2004 and none during 2005. Vaccine effectiveness was high following two or more doses of vaccine. The most urgent future need is for a sustainable routine infant immunization program, including a less expensive vaccine that preferably is delivered in a multivalent form.

• Authors: Paul Daza, Richard Banda, Keystoxe Misoya, Agnes Katsulukuta, Bradford D Gessner, Reggis Katsande, Bekithemba R Mhlanga, Judith E Mueller, Christopher B Nelson, Amos Phiri, Elizabeth M Molyneux, Malcolm E Molyneux
• Journal: Vaccine (Vaccine) Vol. 24 Issue 37-39 Pg. 6232-9 (Sep 11 2006) ISSN: 0264-410X [Print] Netherlands
• PMID: 16806603 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Diphtheria-Tetanus-Pertussis Vaccine
• Haemophilus Vaccines
• Hepatitis B Vaccines
• diphtheria-tetanus-acellular pertussis-Hib-hepatitis B vaccine

Topics

• Age Factors
• Child, Preschool
• Diphtheria-Tetanus-Pertussis Vaccine (immunology, therapeutic use)
• Female
• HIV (immunology)
• HIV Infections (epidemiology, immunology)
• Haemophilus Vaccines (immunology, therapeutic use)
• Haemophilus influenzae type b (immunology)
• Hepatitis B Vaccines (immunology, therapeutic use)
• Humans
• Incidence
• Infant
• Infant, Newborn
• Malawi (epidemiology)
• Male
• Meningitis, Haemophilus (epidemiology, microbiology, prevention & control)
• Prevalence
• Vaccination (methods)