Prevalence of oropharyngeal colonization by Haemophilus influenzae type b in Iranian children

Karimi, Abdollah; Alborzi, Abdolvahab; Fahimzad, Alireza; Gooya, Mohammad-Mehdi; Esteghamati, Abdoulreza; Armin, Shahnaz; Fallah, F

doi:10.26719/2009.15.3.544

Cited by 6 publications

(7 citation statements)

References 16 publications

(15 reference statements)

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“…Age, the place of study, presence of young-siblings, and complete Hib vaccination status were associated with colonization, independently [22]. In Karimi et al's study in Tehran in 2007 before vaccination, out of 1000 children aged ≤5 years from 25 daycare centers, the rate of Hib carriage by a culture method was reported as 7.6% [25]. This study approved that the vaccination has been able to reduce about 60% of the pharyngeal carrier.…”

Section: Discussionmentioning

confidence: 68%

Effect of Haemophilus influenzae Type b Vaccination on Nasopharyngeal Carriage Rate in Children, Tehran, 2019

Tabatabaei

Mohammadzadeh

Zahraei

et al. 2021

BioMed Research International

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Background. Haemophilus influenzae (H. influenzae) strains, which commonly reside as commensals within the human pharynx and can remain as an asymptomatic carrier, but become invasive leading to pneumonia, septic arthritis, or meningitis. The Pentavac (pentavalent vaccine, manufactured by India, SII (DTwP-HepB-Hib)) was introduced to the Iranian National Immunization Plan in November 2014. The aim of this study is to investigate H. influenzae type b (Hib) carrier rate among children under 6 years old in Tehran. Methods. This cross-sectional study was performed on 902 children including vaccinated/unvaccinated in the age of 6 months to 6 years, in Tehran. Sampling was performed from July 2019 to September 2019. Nasopharyngeal samples were taken from children by sterile swab. The PCR method was used to extract DNA. Then, all H. influenzae isolates were initially confirmed by molecular tests. BexA was used to distinguish typeable H. influenzae strains from nontypeable Haemophilus influenzae (NTHi). Results. A total of 902 children were enrolled in the study: 452 were female (51%). H. influenzae carriage rate was 267 (29%), of that 150 samples (16.6%) were typeable. The nasopharyngeal Hib carrier rate in the children was 2.6% (24/902). 262 cases did not receive Hib vaccine. Analysis in nonnursery’s children aged 4 to 6 (unvaccinated) years showed that the lower educational level of father, mother, and family number correlated with increased odds of colonization of children with Hib. Conclusion. Our findings showed a significant decrease (60%) in the overall Hib nasopharyngeal carriage in healthy children under six years after 5 years after the start of Hib vaccination.

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Section: Discussionmentioning

confidence: 68%

Effect of Haemophilus influenzae Type b Vaccination on Nasopharyngeal Carriage Rate in Children, Tehran, 2019

Tabatabaei

Mohammadzadeh

Zahraei

et al. 2021

BioMed Research International

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“…The influenza, rabies and HPV vaccines (all imported from other countries) are available on the market but not in the EPI and there is still a clear lack of availability of Haemophilus influenza type B (Hib) and rotavirus vaccines in EPI. According to an internal study, the prevalence of Hib carriers is 7.6%, similar to other developing countries, yet this vaccine is still not part of the program [5]. The government intends to include these two vaccines in the program; this is dependent both on adding them to the Iranian drug list and the ability of vaccine producers to produce them, which has not been the case so far.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the vaccine industry in Iran in context of accession to WTO: a survey study

et al. 2012

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BackgroundThe vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO) because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations.Purpose of the studyIn this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO.MethodsThis is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry’s key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email.ResultsAccording to the interviewees, the country’s main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP) rules, not being recognized as pre-qualified by the World Health Organization (WHO), the use of old equipment, and a lack of cooperation with global vaccine companies.Major conclusionsIran’s local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP), a lack of adequate and meaningful investment in research and development (R&D), and limitations on private sector participation in the production of vaccines.Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions.

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“…Haemophilus influenzae, a pleomorphic Gram-negative microorganism, can remain as an asymptomatic carrier, but become invasive leading to pneumonia, septic arthritis, or meningitis (1). In 2000, the two leading causes of vaccine preventable diseases in children under five years old were H. influenzae type b (Hib) and Streptococcus pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal Colonization of Haemophilus influenzae Type b and Serologic Response After Administration of Third Dose of Pentavalent Vaccine to 12-Month-Old Children in Karaj, Iran, 2016

Shirvani

Arjmand²,

Golami

et al. 2019

Arch Pediatr Infect Dis

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Background:The administration of Haemophilus influenzae type b (Hib) conjugate vaccine led to a decrease of over 90% in the prevalence of severe Hib diseases in the countries with universal coverage vaccine. After addition of Hib vaccine to the national vaccination program and since no study has yet investigated this subject. Objectives: The current study aimed at investigating the serologic response and assessing oropharyngeal colonization with Hib after the last dose of vaccine. Methods: A total of 500 blood and oropharyngeal samples were collected from one-year-old children referred to Karaj health care centers, Iran. Demographic information and risk factors of the children were collected. Oropharyngeal and blood samples were transferred to the laboratory to determine antibody titer by the enzyme-linked immunosorbent assay (ELISA) technique, culture testing, and polymerase chain reaction (PCR).Results: In the current study, 11.8% of children (95% confidence interval (CI): 8.97 -14.63) had an anti-Hib IgG titer of ≥ 5 µg/mL. Geometric mean titer (GMT) of vaccine antibody was 6.92 µg/mL (95% CI: 6.76 -7.08); 9% of oropharyngeal culture results were positive for H. influaenzae (non-type b) and 8.2% were confirmed by PCR. Prevalence of oropheryngeal Hib colonization was 0.02%. There was no significant correlation between the titer of H. influaenzae antibody and positive culture of H. influaenzae and the other studied variables (P > 0.05). Conclusions: In Iran, similar to most countries, pentavalent vaccine in national vaccination program decreased the prevalence of Hib colonization. Prevalence of Hib colonization is an important factor in invasive diseases incidence. It is suggested that further studies asses the prevalence of invasive Hib diseases after national vaccination.

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Prevalence of oropharyngeal colonization by Haemophilus influenzae type b in Iranian children

Cited by 6 publications

References 16 publications

Effect of Haemophilus influenzae Type b Vaccination on Nasopharyngeal Carriage Rate in Children, Tehran, 2019

Effect of Haemophilus influenzae Type b Vaccination on Nasopharyngeal Carriage Rate in Children, Tehran, 2019

Assessment of the vaccine industry in Iran in context of accession to WTO: a survey study

Oropharyngeal Colonization of Haemophilus influenzae Type b and Serologic Response After Administration of Third Dose of Pentavalent Vaccine to 12-Month-Old Children in Karaj, Iran, 2016

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