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The Elimination of Haemophilus influenzae type b Meningitis Following Conjugate Vaccine Introduction in Senegal

Cissé, Moussa Fafa MD*; Breugelmans, J. Gabrielle PhD, MPH; Bâ, Mamadou MD*; Diop, Mouhamed Boss MD; Faye, Papa Coumba MD, MPH§; Mhlanga, Bekithemba MD; Mueller, Judith E. MD, PhD; Koffi, David MD; Gessner, Bradford D. MD, MPH

The Pediatric Infectious Disease Journal: June 2010 - Volume 29 - Issue 6 - p 499-503
doi: 10.1097/INF.0b013e3181ccb0a0
Original Studies

Background: Senegal introduced routine infant Haemophilus influenzae type b (Hib) conjugate vaccine during 2005.

Methods: We evaluated acute bacterial meningitis surveillance data among children 0 to 59 months of age collected during January 2003 to September 2007 at the major pediatric referral hospital in the Dakar Region of Senegal. Hib vaccine effectiveness was assessed using a case-control design.

Results: A total of 1749 children with suspected bacterial meningitis were included in the current study of whom 142 (8%) had Hib identified. Among children less than age 1 year, the average annual Hib meningitis incidence decreased from 22 to 47 per 100,000 during 2003–2005 to 1.4 per 100,000 during 2007, while pneumococcal meningitis incidence remained stable. Before vaccine introduction, calculated incidences varied over 4-fold between districts within the Dakar Region for the years 2003 to 2005. Following use of Hib vaccine, pneumococcus has now become the most common etiology of pediatric acute bacterial meningitis in Dakar region.

Conclusions: Senegal successfully implemented Hib conjugate vaccine into their routine infant immunization program with a resultant near elimination of Hib meningitis burden.


From the *Children's Hospital Albert Royer, Dakar, Senegal; †Agence de Médecine Préventive Paris, France; ‡World Health Organisation, National Office, Dakar, Senegal; §Ministry of Health Expanded Programme on Immunization, Dakar, Senegal; and ¶World Health Organization, African Regional Office, Harare, Zimbabwe.

Accepted for publication November 20, 2009.

Supported by funds from the World Health Organization, African Regional Office.

Authors J.G.B., B.D.G., J.M. work for Agence de Médecine Préventive, which receives substantial funding for all of its activities from Sanofi Pasteur, a manufacturer of Hib vaccines. In addition, BDG has received speakers' fees and JM consultation honorary from Glaxo-Smith-Kline.

Address for Correspondence: Bradford D. Gessner, Agence de Médecine Préventive. Institut Pasteur, 28 rue du Docteur Roux, 75015, Paris, France. E-mail:

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© 2010 Lippincott Williams & Wilkins, Inc.