Yaro Seydou, Lourd Mathilde, Naccro B, Njanpop-Lafourcade Berthe-Marie, Hien Alain, Ouedraogo Macaire S, Traore Yves, Schouls Leo M, Parent du Châtelet Isabelle, Gessner Bradford D
Centre Muraz, Bobo-Dioulasso, Burkina Faso.
Pediatr Infect Dis J. 2006 May;25(5):415-9. doi: 10.1097/01.inf.0000217371.38080.8a.
Haemophilus influenzae type b (Hib) disease burden studies are important to conduct in African countries that plan to introduce vaccine so that vaccine impact can be documented.
We implemented population-based meningitis surveillance in 3 districts of Burkina Faso for 12 months each during 2002-2003 and 2004-2005 using polymerase chain reaction, culture and antigen detection.
Lumbar puncture was performed on 1686 patients and 112 had Hib identified. Persons <1, <5, 5-14 and 15+ years of age had annual Hib meningitis incidences of 97, 34, 2.1 and 0.55 per 100,000, respectively; overall case fatality proportion was 25%. During the historic meningitis epidemic season months of December through April, the proportion of purulent cerebrospinal fluid among children aged <5 years that yielded Hib was 27% compared with 30% during other months. Twenty-five of 98 persons with information available were treated with only one or 2 doses of oily chloramphenicol. Among children age <5 years with Hib meningitis, 28% were pretreated with antimalarials and antimalarial pretreatment was associated with delay in hospitalization.
In Burkina Faso, Hib meningitis incidence and case fatality proportion are high and thus vaccine could have a substantial impact. While awaiting well-implemented routine infant Hib vaccination, empiric case management for pediatric meningitis in sub-Saharan Africa must recognize that Hib is likely even during the epidemic season. In malaria-endemic areas, pediatric Hib meningitis case management may be adversely affected by the similar presentation of these 2 diseases.
对于计划引入疫苗的非洲国家而言，开展b型流感嗜血杆菌（Hib）疾病负担研究十分重要，这样才能记录疫苗的影响。
在2002 - 2003年以及2004 - 2005年期间，我们在布基纳法索的3个地区开展了基于人群的脑膜炎监测，每次为期12个月，采用聚合酶链反应、培养和抗原检测方法。
对1686例患者进行了腰椎穿刺，其中112例确诊为Hib感染。1岁以下、1 - 5岁、5 - 14岁和15岁及以上人群的Hib脑膜炎年发病率分别为每10万人97例、34例、2.1例和0.55例；总体病死率为25%。在12月至次年4月这一历史性脑膜炎流行季节期间，5岁以下儿童中脑脊液脓性且检出Hib的比例为27%，其他月份为30%。98例有可用信息的患者中，25例仅接受了1或2剂油性氯霉素治疗。在5岁以下患Hib脑膜炎的儿童中，28%曾接受抗疟药预处理，且抗疟药预处理与住院延迟有关。
在布基纳法索，Hib脑膜炎发病率和病死率较高，因此疫苗可能会产生重大影响。在等待全面实施常规婴儿Hib疫苗接种期间，撒哈拉以南非洲地区小儿脑膜炎的经验性病例管理必须认识到，即使在流行季节Hib感染也很可能存在。在疟疾流行地区，这两种疾病相似的临床表现可能会对小儿Hib脑膜炎的病例管理产生不利影响。
