Bacterial Meningitis and Hib Vaccine, Malawi | CDC EID

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Volume 17, Number 4–April 2011
Dispatch
Bacterial Meningitis and Haemophilus influenzae Type b Conjugate Vaccine, Malawi
David W. McCormick and Elizabeth M. Molyneux

Author affiliations: University of Michigan, Ann Arbor, Michigan, USA (D.W. McCormick); and College of Medicine, Blantyre, Malawi (E.M. Molyneux)

Suggested citation for this article

Abstract
A retrospective database review showed that Haemophilus influenzae type b conjugate vaccine decreased the annual number of cases of H. influenzae type b meningitis in children in Blantyre, Malawi. Among young bacterial meningitis patients, HIV prevalence was high (36.7% during 1997–2009), and pneumococcus was the most common etiologic agent (57% in 2009).

Acute bacterial meningitis (ABM) is a major cause of illness and death in children in sub-Saharan Africa (1,2). Neisseria meningitidis is the most common cause of ABM in the meningitis belt (sub-Saharan Africa), and Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) are the most common causes in southern and eastern Africa (1–4). Of 114 case-patients with meningitis and positive cerebrospinal fluid (CSF) cultures who came to the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi (southeastern Africa), during 1996–1997, more than half of these cases were caused by S. pneumoniae, Hib, or Salmonella spp. (5).

In February 2002, Malawi introduced Hib conjugate vaccine in a pentavalent formulation that includes vaccine against diphtheria, pertussis, tetanus, and hepatitis B. There was no mass campaign or catch-up program. This vaccine is given routinely to patients at 6, 10, and 14 weeks of age; vaccination coverage has been ≈90% since 2002 (http://apps.who.int/immunization_monitoring/en/globalsummary/countryprofileresult.cfm). Incidence of Hib meningitis decreased but the long-term effect of the vaccination program remains unclear (6). We examined the effectiveness of Hib conjugate vaccine by conducting a retrospective database review of children with ABM who came to QECH in Blantyre, Malawi during 1997–2009.



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Bacterial Meningitis and Hib Vaccine, Malawi | CDC EID


Suggested Citation for this Article
McCormick DW, Molyneux EM. Bacterial meningitis and Haemophilus influenzae type b conjugate vaccine, Malawi. Emerg Infect Dis [serial on the Internet]. 2011 Apr [date cited].
http://www.cdc.gov/EID/content/17/4/688.htm


DOI: 10.3201/eid1704.101045


Comments to the Authors
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David W. McCormick, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA; email: dwmccor@umich.edu