Impact of conjugate Haemophilus influenzae type b (Hib) vaccine introduction in South Africa

Bull World Health Organ. 2006 Oct;84(10):811-8. doi: 10.2471/blt.06.030361.

Abstract

Objective: To analyse trends in reported invasive Haemophilus influenzae disease in South Africa within the first five years of introduction of conjugate Haemophilus influenzae type b (Hib) vaccine in the routine child immunization schedule.

Methods: We used national laboratory-based surveillance data to identify cases of invasive H. influenzae disease between July 1999 and June 2004, and submitted isolates for serotyping and antimicrobial susceptibility testing.

Findings: The absolute number of Hib cases (reported to the national surveillance system) among children below one year of age decreased by 65%, from 55 cases in 1999-2000 to 19 cases in 2003-04. Enhanced surveillance initiated in 2003, identified human immunodeficiency virus (HIV)-infection and incomplete vaccination as contributing factors for Hib transmission. The total number of laboratory-confirmed cases of H. influenzae remained unchanged because non-type b disease was being increasingly reported to the surveillance system concomitant with system enhancements. Children with non-typable disease were more likely to be HIV-positive (32 of 34, 94%) than children with Hib disease (10 of 14, 71%), P = 0.051. Recent Hib isolates were more likely to be multidrug resistant (2% in 1999-2000 versus 19% in 2003-04, P = 0.001).

Conclusion: Data from a newly established national laboratory-based surveillance system showed a decrease in Hib disease burden among South African children following conjugate vaccine introduction and identified cases of non-typable disease associated with HIV infection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Bacterial Capsules
  • Child Health Services*
  • Child, Preschool
  • Female
  • Haemophilus Infections / epidemiology
  • Haemophilus Infections / microbiology
  • Haemophilus Infections / prevention & control*
  • Haemophilus Vaccines*
  • Haemophilus influenzae type b / immunology*
  • Humans
  • Immunization Schedule
  • Infant
  • Infant, Newborn
  • Male
  • Outcome Assessment, Health Care
  • Polysaccharides, Bacterial*
  • Population Surveillance
  • South Africa / epidemiology
  • Vaccines, Conjugate

Substances

  • Haemophilus Vaccines
  • Haemophilus influenzae type b polysaccharide vaccine
  • Polysaccharides, Bacterial
  • Vaccines, Conjugate