Roca Anna, Quintó Llorenç, Abacassamo Fatima, Morais Luis, Vallès Xavi, Espasa Mateu, Sigaúque Betuel, Sacarlal Jahit, Macete Eusebio, Nhacolo Ariel, Mandomando Inacio, Levine Myron M, Alonso Pedro L
Centre de Recerca en Salut Internacional de Barcelona, Universitat de Barcelona, Barcelona, Spain.
Trop Med Int Health. 2008 Jun;13(6):818-26. doi: 10.1111/j.1365-3156.2008.02061.x. Epub 2008 Apr 4.
To measure the disease burden and epidemiological characteristics of invasive Haemophilus influenzae in rural Mozambican children.
As part of the clinical management of children admitted to Manhiça District Hospital, blood and cerebrospinal fluid samples were collected between May 2001 and April 2005 for children aged <5 years. The level of antibiotic resistance of the isolates was analysed.
During the surveillance period, there were 106 episodes of invasive H. influenzae disease. The estimated minimum incidence rate of invasive disease among children <5 years of age was 125/100,000 per child-year-at-risk. Fifty-six (59/106) per cent of cases were infants aged 3 to <12 months. Confirmed meningitis explained 16% of the episodes (n = 17) but was probably underestimated, as meningitis surveillance was not well implemented in the setting during the study. The case-fatality-rate was 21%, being highest among children with meningitis (odds ratio = 4.38, P = 0.011). Resistance to the antibiotics most commonly used in Mozambique was high--chloramphenicol 39%, ampicillin 35% and cotrimoxazol 74%-- and had increased over the years (P < 0.001 for chloramphenicol).
Invasive H. influenzae disease is of considerable public health importance in Mozambique; implementing H. influenzae type b vaccination in sub-Saharan Africa has the potential to increase child survival.
测定莫桑比克农村地区儿童侵袭性流感嗜血杆菌的疾病负担和流行病学特征。
作为马尼卡区医院收治儿童临床管理工作的一部分，于2001年5月至2005年4月期间，收集了年龄小于5岁儿童的血液和脑脊液样本。对分离菌株的抗生素耐药水平进行了分析。
在监测期间，共发生106例侵袭性流感嗜血杆菌病。估计5岁以下儿童侵袭性疾病的最低发病率为每儿童年高危人群125/100,000。56%（59/106）的病例为3至12月龄婴儿。确诊的脑膜炎占病例的16%（n = 17），但可能被低估了，因为在研究期间该地区脑膜炎监测工作执行得不好。病死率为21%，在脑膜炎患儿中最高（优势比 = 4.38，P = 0.011）。莫桑比克最常用抗生素的耐药率很高——氯霉素为39%，氨苄西林为35%，复方新诺明为74%——且多年来有所上升（氯霉素P < 0.001）。
侵袭性流感嗜血杆菌病在莫桑比克具有相当大的公共卫生重要性；在撒哈拉以南非洲实施b型流感嗜血杆菌疫苗接种有可能提高儿童存活率。
