International Center for Diarrheal Disease Research-B, Dhaka, Bangladesh.
J Pediatr. 2013 Jul;163(1 Suppl):S73-8. doi: 10.1016/j.jpeds.2013.03.033.
Some Asian countries have been reluctant to adopt Haemophilus influenzae type b (Hib) conjugate vaccination because of uncertainty over disease burden. We assessed the impact of introduction of Hib conjugate vaccine into the Expanded Program on Immunization in Bangladesh on purulent and laboratory-confirmed H influenzae meningitis.
Within a well-defined catchment area around 2 surveillance hospitals in Dhaka, Bangladesh, we compared the incidence of Hib meningitis confirmed by culture, latex agglutination, and polymerase chain reaction assay among infants 1 year before and 1 year after introduction of Hib conjugate vaccine. We adjusted the incidence rate for the proportion of children who sought care at the surveillance hospitals.
Among infants, the incidence of confirmed Hib meningitis decreased from 92-16 cases per 100,000 within 1 year of vaccine introduction (vaccine preventable incidence = 76; 95% CI 18, 135 per 100,000). The incidence of purulent meningitis decreased from 1659-1159 per 100,000 (vaccine preventable incidence = 500; 95% CI: 203, 799 per 100,000). During the same time period, there was no significant difference in the incidence of meningitis due to Streptococcus pneumoniae.
Introduction of conjugate Hib conjugate vaccine into Bangladesh Expanded Program on Immunization markedly reduced the burden of Hib and purulent meningitis.
由于对疾病负担的不确定性，一些亚洲国家一直不愿采用乙型流感嗜血杆菌（Hib）结合疫苗。我们评估了将 Hib 结合疫苗引入孟加拉国扩大免疫规划对化脓性和实验室确诊的流感嗜血杆菌脑膜炎的影响。
在孟加拉国达卡的 2 家监测医院周围的一个明确界定的范围内，我们比较了在引入 Hib 结合疫苗之前和之后的 1 年中，通过培养、乳胶凝集和聚合酶链反应检测确诊的 Hib 脑膜炎的发病率。我们根据在监测医院寻求治疗的儿童比例调整了发病率。
在婴儿中，确诊 Hib 脑膜炎的发病率从疫苗接种后 1 年内的每 100,000 人中 92-16 例下降（疫苗可预防发病率为 76；95%CI 18，135/100,000）。化脓性脑膜炎的发病率从每 100,000 人 1659-1159 例下降（疫苗可预防发病率为 500；95%CI：203，799/100,000）。在此期间，肺炎链球菌引起的脑膜炎发病率没有显著差异。
将 Hib 结合疫苗引入孟加拉国扩大免疫规划显著降低了 Hib 和化脓性脑膜炎的负担。
