Impact of Haemophilus influenzae type b conjugate vaccine on bacterial meningitis in the Dominican Republic

Abstract

Introduction of Hib vaccine substantially reduced the incidence of confirmed and probable bacterial meningitis in the Dominican Republic. The estimated impact of Hib vaccination was twice as great when non-culture-confirmed disease was included.

Bacterial meningitis and living conditions

“…Since bacterial meningitis involves various etiological agents with different clinical and epidemiological characteristics, epidemiological studies are not traditionally used to consider these infections as a group, and that includes the studies designed and conducted in Brazil. Nevertheless, a similar trend to that found in this study for these types of meningitis was also reported in Santo Domingo, Dominican Republic, albeit only for children aged <5 years and for the period 1998-2004, with the exception of meningococcal meningitis, which remained stable throughout this period 9 .…”

“…Despite the decline, the incidence levels of these infections remain high in Salvador, principally in children aged <5 years, with an incidence of almost 22 cases/100,000 inhabitants in this age group, a lower rate than that registered in Romania (33 cases/100,000 inhabitants) 34 , but higher than that recorded in Santo Domingo, Dominican Republic (16 cases/100,000 inhabitants) 9 . As reported in previous studies 2,13,22,35 , males have a higher risk of being infected by bacterial meningitis in Salvador.…”

“…The last 2 are the predominant etiological agents in countries where the Hib conjugate vaccine is used routinely [6][7][8][9][10] . Despite the positive effect obtained with the widespread use of this vaccine and also the growing trend toward the use of meningococcal and pneumococcal conjugate vaccines of specific serogroups or serotypes, these forms of meningitis remain a significant public health problem in poorer countries and regions, particularly among children 6,7,9,[11][12][13][14][15][16] .…”

“…In Brazil, bacterial meningitis is common and, as in other developing countries, affects mainly children under the age of 5 years 9,11 . Over the past 4 years, its incidence has been ~4 cases/100,000 inhabitants 17 and the mean fatality for the 1990-2008 period was 19.1% 18 .…”

Haemophilus influenzae type b conjugate vaccines – A South African perspective

“…As part of an extensive meta-analysis performed by O'Loughlin et al in 2010, vaccine efficacy against invasive disease was found to be 95% (95% CI 82-99) [78]. This corresponds well with a Cochrane review on this matter [81], as well as various geographically diverse studies [9,[82][83][84][85][86][87].…”