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

Vaccine. 2006 Sep 11;24(37-39):6232-9. doi: 10.1016/j.vaccine.2006.05.076. Epub 2006 Jun 9.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

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