Ruocco G, Curto S, Savio M, Laurani H, Frocht R
Ministerio de Salud Pública, División de Epidemiología, Montevideo, Uruguay.
Rev Panam Salud Publica. 1999 Mar;5(3):197-9. doi: 10.1590/s1020-49891999000300021.
Between 1979 and 1994, epidemiological surveillance of meningitides in Uruguay showed a progressive increase in suppurative meningitides due mainly to Neisseria meningitidis and Haemophilus influenzae type b (Hib). The cases were concentrated in children under 5; however, among the cases caused by Hib, 70% affected children from 1 to 11 months old. Facing this situation, the Ministry of Public Health resolved, as of August 1994, to include the Hib vaccine in the country's Expanded Program on Immunization, which has been in place since 1982. The Hib vaccination is done without charge and is obligatory for all children under 5 years of age. It is done using the following series of vaccinations: a) three doses, given at 2, 4, and 6 months, with a booster dose at age 1; b) children from 7 to 11 months old receive two doses two months apart and a booster dose a year later; and c) a single dose for children 12 months to 4 years old. Between August and December 1994 a coverage rate of 76.6% was reached among children between 2 months and 4 years old, and the coverage has remained above 80% in the new cohorts. In Uruguay, this vaccination strategy had a spectacular impact on morbidity and mortality due to meningitides caused by Hib. One of the results was that the incidence of 15.6 per 100,000 registered in children under 5 in the prevaccination years declined to 0.03 per 100,000 in 1996.
1979年至1994年间，乌拉圭的脑膜炎流行病学监测显示，主要由脑膜炎奈瑟菌和b型流感嗜血杆菌（Hib）引起的化脓性脑膜炎呈逐渐上升趋势。病例集中在5岁以下儿童；然而，在由Hib引起的病例中，70%的患儿年龄在1至11个月之间。面对这种情况，公共卫生部于1994年8月决定将Hib疫苗纳入自1982年起实施的国家扩大免疫规划。Hib疫苗接种免费，所有5岁以下儿童必须接种。接种采用以下一系列接种方案：a）在2、4和6个月时接种三剂，1岁时加强一剂；b）7至11个月大的儿童每隔两个月接种两剂，一年后加强一剂；c）12个月至4岁的儿童接种一剂。1994年8月至12月期间，2个月至4岁儿童的接种率达到76.6%，新队列的接种率一直保持在80%以上。在乌拉圭，这种疫苗接种策略对由Hib引起的脑膜炎的发病率和死亡率产生了显著影响。结果之一是，接种疫苗前几年5岁以下儿童每10万人中15.6例的发病率在1996年降至每10万人0.03例。
