2008 - 2013年冈比亚东部基于人群的监测：b型流感嗜血杆菌导致的疾病增加

Increased disease due to Haemophilus influenzae type b: population-based surveillance in eastern Gambia, 2008-2013.

作者信息

Mackenzie Grant A, Ikumapayi Usman N A, Scott Susana, Idoko Olubukola, Odutola Aderonke, Ndiaye Malick, Sahito Shah M, Osuorah Chidiebereh D, Manjang Ahmed, Jarju Sheikh, Bojang Abdoulie, Roca Anna, Secka Ousman, Zaman Akram, Ceesay Lamin, Lowe-Jallow Yamundow, Sambou Sana, Jasseh Momodou, Antonio Martin, Greenwood Brian, Kampmann Beate, Mulholland Kim, Corrah Tumani, Howie Stephen R C

机构信息

From the *Medical Research Council, The Gambia Unit, The Gambia; †Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; ‡Ministry of Health and Social Welfare, Gambia Government, The Quadrangle, Banjul, The Gambia; §London School of Hygiene and Tropical Medicine, London, United Kingdom; and ¶ University of Otago, Dunedin, New Zealand.

出版信息

Pediatr Infect Dis J. 2015 May;34(5):e107-12. doi: 10.1097/INF.0000000000000645.

DOI:10.1097/INF.0000000000000645

PMID:25879650

Abstract

BACKGROUND

In 1997, The Gambia became the first African country to introduce conjugate Haemophilus influenzae type b (Hib) vaccine with good disease control through to 2010.

METHODS

Culture-based surveillance for invasive bacterial disease in eastern Gambia, specifically the Basse Health and Demographic Surveillance System (BHDSS) area, was conducted from 12 May 2008 and in Fuladu West district from 12 September 2011 until 31 December 2013. In 2011, Hib serology was measured in 5-34-year-olds.

RESULTS

In all, 16,735 of 17,932 (93%) eligible patients were investigated. We detected 57 cases of invasive H. influenzae disease; 24 (42%) were type b. No cases of Hib disease were detected in the BHDSS area in 2008-2009; 1 was detected in 2010, 2 in 2011, 4 in 2012 and 7 in 2013. In 2013, the incidence of Hib disease in those aged 2-11 and 2-59 months in the BHDSS area was 88 [95% confidence interval (CI): 29-207] and 22 (95% CI: 9-45) cases per 10⁵ person-years, respectively. In 2013, disease incidence in Fuladu West among those aged 0-59 months was 26 (95% CI: 7-67) cases per 10⁵ person-years. Nine of 24 Hib cases were vaccine failures (2 HIV positive) and 9 were too young to have been vaccinated. The proportion of children aged 5-6 years (n = 223) with anti-Hib IgG ≥1.0 μg/mL was 67%; the antibody nadir was in 9-14-year-olds (n = 58) with 55% above threshold.

CONCLUSIONS

Hib disease in eastern Gambia has increased in recent years. Surveillance in developing countries should remain alert to detect such changes.

摘要

背景

1997年，冈比亚成为首个引入b型流感嗜血杆菌（Hib）结合疫苗的非洲国家，到2010年疾病得到了有效控制。

方法

2008年5月12日起，在冈比亚东部开展基于培养的侵袭性细菌病监测，具体为巴塞健康与人口监测系统（BHDSS）地区；2011年9月12日至2013年12月31日，在富拉杜西区开展监测。2011年，对5至34岁人群进行了Hib血清学检测。

结果

总共对17932名符合条件的患者中的16735名（93%）进行了调查。我们检测到57例侵袭性流感嗜血杆菌病；其中24例（42%）为b型。2008 - 2009年，BHDSS地区未检测到Hib病病例；2010年检测到1例，2011年检测到2例，2012年检测到4例，2013年检测到7例。2013年，BHDSS地区2至11岁和2至59个月儿童的Hib病发病率分别为每10⁵人年88例[95%置信区间（CI）：29 - 207]和22例（95%CI：9 - 45）。2013年，富拉杜西区0至59个月儿童的疾病发病率为每10⁵人年26例（95%CI：7 - 67）。24例Hib病例中有9例疫苗接种失败（2例HIV阳性），9例因年龄太小未接种疫苗。5至6岁儿童（n = 223）中抗Hib IgG≥1.0μg/mL的比例为67%；抗体最低点出现在9至14岁儿童（n = 58）中，55%高于阈值。