Impact of Haemophilus influenzae Type b Conjugate Vaccine in Mongolia: Prospective Population-Based Surveillance, 2002-2010

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• 作者：Susana Scott ; PhD¹ ; ^{susana.scott@lshtm.ac.uk} ; Dorjpurev Altanseseg ; MD ; PhD² ; Demberelsuren Sodbayer ; MD ; MPH³ ; Pagvajav Nymadawa ; MD ; PhD ; DSc² ; Davaadash Bulgan ; MD ; PhD² ; Jamsran Mendsaikhan ; MD ; PhD³ ; James P. Watt ; MD ; MPH⁴ ; Mary P.E. Slack ; MA ; MBBChir ; FRCPath⁵ ; Maria G. Carvalho ; PhD⁶ ; Rana Hajjeh ; MD⁶ ; Karen M. Edmond ; MBBS ; MSc ; MTPH ; FRACP¹ ; ⁷
• 关键词：CSF ; Cerebrospinal fluid ; Hib ; Haemophilus influenzae type b ; NCCD ; National Center of Communicable Diseases ; PCR ; Polymerase chain reaction
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：163
• 期：1_supp_S
• 页码：S8-S11
• 全文大小：221 K

文摘

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Objectives

Bacterial meningitis is associated with high mortality and long-term complications. This study assessed the impact of Haemophilus influenzae type b (Hib) conjugate vaccine on childhood bacterial meningitis in Ulaanbaatar, Mongolia.

Study design

Prospective, active, population-based surveillance for suspected meningitis in children aged 2-59 months was conducted (February 2002-January 2011) in 6 hospitals. Clinical data, blood, and cerebrospinal fluid were collected. The impact of Hib conjugate vaccine was assessed by comparing Hib and all cause meningitis data in the 3 years preceding pentavalent conjugate vaccine implementation (2002-2004) with 3 years postimplementation (2008-2010).

Results

Five hundred eleven cases of suspected meningitis were identified from 2002-2011. Pentavalent conjugate vaccine coverage in December 2005 in Ulaanbaatar city was 97 % . The proportion of suspected cases confirmed as Hib meningitis decreased from 25 % (50/201) in the prevaccination era to 2 % (4/193) in the postvaccination era (P?<?.0001). The annual incidence of Hib decreased from 28 cases per 100?000 children in 2002-2005 to 2 per 100?000 in 2008-2010 (P < .0001).

Conclusions

This article demonstrates the marked impact of Hib conjugate vaccine introduction on meningitis?in Mongolia. It is important to sustain this surveillance system to monitor the long-term impact of Hib conjugate vaccine, as well as other interventions such as pneumococcal and meningococcal vaccines.