Skip Navigation LinksHome > July 2007 - Volume 26 - Issue 7 > Effectiveness of Haemophilus influenzae Type B Conjugate Vac...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31806166a0
Original Studies

Effectiveness of Haemophilus influenzae Type B Conjugate Vaccine on Prevention of Pneumonia and Meningitis in Bangladeshi Children: A Case–Control Study

Baqui, Abdullah H. MBBS, MPH, DrPH*; El Arifeen, Shams MBBS, MPH, DrPH†; Saha, Samir K. PhD‡; Persson, LarsÅke MD§; Zaman, K MBBS, PhD†; Gessner, Bradford D. MD∥; Moulton, Lawrence H. PhD*; Black, Robert E. MD, MPH*; Santosham, Mathuram MD, MPH*

Collapse Box

Abstract

Background: Few Asian countries have introduced Haemophilus influenzae type b (Hib) conjugate vaccine because of its cost and uncertainty regarding disease burden.

Methods: To estimate the effectiveness of Hib conjugate vaccine in preventing pneumonia and meningitis in children age <2 years, an incident case–control study was conducted in a birth cohort of about 68,000 infants in Dhaka city, Bangladesh. DPT vaccine was systematically replaced by a combined Hib-DPT vaccine in selected immunization centers of the study area. Four matched community- and 2 hospital-controls were randomly selected for each confirmed case of pneumonia and meningitis from the study area.

Results: About 35% of the infants received each of the 3 doses of Hib-DPT vaccine. There were 2679 children who had a chest roentgenogram. For 475 children, a radiologist and a pediatrician independently identified substantial alveolar consolidation. Following at least 2 doses of Hib vaccine, the preventable fractions [95% confidence intervals (CI)] using community and hospital controls were 17% (−10% to 38%) and 35% (13% to 52%) respectively. Of these 475 cases, 2 radiologists with the World Health Organization concurred with the findings for 343 patients, yielding preventable fractions of 34% (6% to 53%) and 44% (20% to 61%). Fifteen confirmed Hib meningitis cases were identified; the preventable fractions (95% CI) using community and hospital controls, respectively, were 89% (28% to 100%) and 93% (53% to 100%).

Conclusions: The study documented that significant fractions of pneumonia and meningitis in Bangladeshi children age <2 years can be prevented by the Hib conjugate vaccine.

© 2007 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.