Skip Navigation LinksHome > May 2006 - Volume 25 - Issue 5 > The Epidemiology of Haemophilus influenzae Type b Meningitis...
Pediatric Infectious Disease Journal:
doi: 10.1097/01.inf.0000217371.38080.8a
Original Studies

The Epidemiology of Haemophilus influenzae Type b Meningitis in Burkina Faso

Yaro, Seydou MD*; Lourd, Mathilde MPH†; Naccro, B MD; for the Clinical Group; Njanpop-Lafourcade, Berthe-Marie PhD†; Hien, Alain PharmD; for the Laboratory Group; Ouedraogo, Macaire S. MD†; Traore, Yves PhD§; Schouls, Leo M. PhD∥; du Châtelet, Isabelle Parent MD†; Gessner, Bradford D. MD†

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Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

© 2006 Lippincott Williams & Wilkins, Inc.

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