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.
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.
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.
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.
From *Centre Muraz, Bobo-Dioulasso, Burkina Faso; the †Association pour l'Aide à la Médecine Préventive, Paris, France; the ‡Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso; §Université de Ouagadougou, Ouagadougou, Burkina Faso; and the ∥Laboratory for Vaccine-Preventable Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
Accepted for publication January 18, 2006.
The Clinical Group: Adrien Sawadogo, Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso; Pascal Korgho, Flore Ouedraogo, and Francine Ouedraogo, Direction Régionale de la Santé, Ministère de la Santé, Bobo-Dioulasso, Burkina Faso. The Laboratory Group: Sanou Oumarou, Association pour l'Aide à la Médecine Préventive, Paris, France; Dominique Niamba, Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso; Ali Drabo, Centre Muraz, Bobo-Dioulasso, Burkina Faso; Lansina Sangare, Université de Ouagadougou, Ouagadougou, Burkina Faso; and Francis Hien, Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso.
Financial support for this study provided by Sanofi-Pasteur, Institut Pasteur, and the Bill and Melinda Gates Foundation.
Address for correspondence: Bradford D. Gessner, MD, Association Pour l'Aide à la Médecine Préventive, Institut Pasteur, 28 rue du Docteur Roux, 75015, Paris, France; E-mail firstname.lastname@example.org.