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

Authors

Ellen H. Lee, Centers for Disease Control
Miriam Corcino, Programa Ampliado de Inmunización, Secretaría de Estado de Salud Pública y Asistencia Social, Santo Domingo, Dominican Republic
Arelis Moore de Peralta, Clemson UniversityFollow
Zacarias Garib, Programa Ampliado de Inmunización, Secretaría de Estado de Salud Pública y Asistencia Social, Santo Domingo, Dominican Republic
Chabela Peña, Departamento de Enfermedades Infecciosas, Clínica Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
Jacquelin Sánchez, Departamento de Enfermedades Infecciosas, Clínica Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
Josefina Fernández, Departamento de Enfermedades Infecciosas, Clínica Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
Jesús M. Feris-Iglesias, Departamento de Enfermedades Infecciosas, Clínica Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
Brendan Flannery, National Center for Immunizations and Respiratory Diseases

Document Type

Article

Publication Date

9-2008

Publication Title

Pan American Journal of Public Health

Volume

24

Issue

3

Publisher

Pan American Health Organization

DOI

10.1590/s1020-49892008000900002

Abstract

OBJECTIVES:

Widespread use of Haemophilus influenzae type b (Hib) vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningitis before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis.

METHODS:

Meningitis cases among children < 5 years of age were identified from admission records of the main pediatric hospital in Santo Domingo during 1998-2004. Laboratory criteria were used to classify meningitis cases with probable bacterial etiology; confirmed cases had positive bacterial culture or antigen detection in cerebrospinal fluid. Cumulative incidence rates of confirmed and probable bacterial meningitis were calculated for children living in the National District. Confirmed cases of Hib meningitis were enrolled in a case-control study with age- and neighborhood-matched control children to calculate vaccine effectiveness.

RESULTS:

Before vaccine introduction, annual rates of meningitis with probable bacterial etiology were 49 cases per 100 000 children < 5 years old; Hib accounted for 60% of confirmed bacterial cases. During 2002-2004, after vaccine introduction, annual rates of probable bacterial meningitis were 65% lower at 16 cases per 100 000, and Hib accounted for 26% of confirmed cases. Rates of Hib meningitis and probable bacterial meningitis with no determined etiology declined by 13 and 17 cases per 100 000, respectively.

CONCLUSIONS:

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.

Recommended Citation

Lee, Ellen H.; Corcino, Miriam; Moore de Peralta, Arelis; Garib, Zacarias; Peña, Chabela; Sánchez, Jacquelin; Fernández, Josefina; Feris-Iglesias, Jesús M.; and Flannery, Brendan, "Impact of Haemophilus influenzae type b conjugate vaccine on bacterial meningitis in the Dominican Republic" (2008). Publications. 100.
https://open.clemson.edu/languages_pubs/100