Impact of routine vaccination against Haemophilus influenzae type b in The Gambia: 20 years after its introduction

被引：9

作者：

Zaman, Syed M. A. ^{[1
,2
,3
]}

Howie, Stephen R. C. ^{[1
,4
]}

Ochoge, Magnus ^{[1
]}

Secka, Ousman ^{[1
]}

Bah, Alasana ^{[1
]}

Baldeh, Ignatius ^{[5
]}

Sanneh, Bakary ^{[5
]}

Darboe, Saffiatou ^{[1
]}

Ceesay, Buntung ^{[1
]}

Camara, Haddy Bah ^{[6
]}

Mawas, Fatme ^{[7
]}

Ndiaye, Malick ^{[1
]}

Hossain, Ilias ^{[1
]}

Salaudeen, Rasheed ^{[1
]}

Bojang, Kalifa ^{[1
]}

Ceesay, Samba ^{[8
]}

Sowe, Dawda ^{[8
]}

Hossain, M. Jahangir ^{[1
]}

Mulholland, Kim ^{[2
,9
]}

Kwambana-Adams, Brenda A. ^{[1
]}

Okoi, Catherine ^{[1
]}

Badjie, Siaka ^{[1
]}

Ceesay, Lamin ^{[10
]}

Mwenda, Jason M. ^{[11
]}

Cohen, Adam L. ^{[12
]}

Agocs, Mary ^{[13
]}

Mihigo, Richard ^{[11
]}

Bottomley, Christian ^{[14
]}

Antonio, Martin ^{[1
,15
,16
]}

Mackenzie, Grant A. ^{[1
,9
,17
,18
,19
]}

机构：

[1] London Sch Hyg & Trop Med, Med Res Council Unit Gambia, Fajara, Gambia

[2] London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England

[3] Univ Liverpool Liverpool Sch Trop Med, Educ Dept, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

[4] Univ Auckland, Dept Paediat, Auckland, New Zealand

[5] Minist Hlth & Social Welf, Natl Publ Hlth Lab, Kotu, Gambia

[6] Minist Hlth & Social Welf, Edward Francis Small Teaching Hosp, Banjul, Gambia

[7] Natl Inst Biol Stand & Control NIBSC, Potters Bar, Herts, England

[8] Minist Hlth & Social Welf, Directorate Hlth Serv, Banjul, Gambia

[9] Murdoch Childrens Res Inst, Melbourne, Vic, Australia

[10] Minist Hlth & Social Welf, Expanded Programme Immunizat, Kotu, Gambia

[11] WHO, Reg Off Africa, Brazzaville, Rep Congo

[12] WHO, Geneva, Switzerland

[13] Amer Red Cross, Washington, DC 20006 USA

[14] London Sch Hyg & Trop Med, MRC Trop Epidemiol Grp, London, England

[15] London Sch Hyg & Trop Med, Dept Pathogen Mol Biol, London, England

[16] Univ Warwick, Warwick Med Sch, Microbiol & Infect Unit, Coventry, W Midlands, England

[17] London Sch Hyg & Trop Med, Dept Dis Control, London, England

[18] Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia

[19] Inst Rech Sante Surveillance Epidemiol & Format, Dakar, Senegal

来源：

JOURNAL OF GLOBAL HEALTH | 2020年 / 10卷 / 01期

基金：

英国医学研究理事会; 比尔及梅琳达.盖茨基金会;

关键词：

POPULATION-BASED-SURVEILLANCE; CONJUGATE VACCINE; HIB DISEASE; ELIMINATION; PROTECTION; ANTIBODY; CHILDREN;

D O I：

10.7189/jogh.10.010416

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background In 1997, The Gambia introduced three primary doses of Haemophilus influenzae type b (Hib) conjugate vaccine without a booster in its infant immunisation programme along with establishment of a population-based surveillance on Hib meningitis in the West Coast Region (WCR). This surveillance was stopped in 2002 with, reported elimination of Hib disease. This was re-establiShed in 2008 but stopped again in 2010. We aimed to re-establish the surveillance in WCR and to continue surveillance in Basse Health and Demographic Surveillance System (BHDSS) in the east of the country to assess any shifts in the epidemiology of Hib disease in The Gambia. Methods In WCR, population-based surveillance for Hib meningitis was re-established in children aged under-10 years from 24 December 2014 to 31 March 2017, using conventional microbiology and Real Time Polymerase Chain Reaction (RT-PCR). In BHDSS, population-based surveillance for Hib disease was conducted in children aged 2-59 months from 12 May 2008 to 31 December 2017 using conventional microbiology only. Hib carriage survey was carried out in pre-school and school children from July 2015 to November 2016. Results In WCR, five Hib meningitis cases were detected using conventional microbiology while another 14 were detected by RT-PCR. Of the 19 cases, two (11%) were too young to be protected by vaccination while seven (37%) were unvaccinated. Using conventional microbiology, the incidence of Hib meningitis per 100000-child-year (Cy) in children aged 1-59 months was 0.7 in 2015 (95% confidence interval (CI) = 0.0-3.7) and 2.7 (95% CI =0.7-7.0) in 2016. In BHDSS, 25 Hib cases were reported. Nine (36%) were too young to be protected by vaccination and five (20%) were under-vaccinated for age. Disease incidence peaked in 2012-2013 at 15 per 100 000 CY and fell to 5-8 per 100 000 CY over the subsequent four years. The prevalence of Hib carriage was 0.12% in WCR and 0.38% in BHDSS. Conclusions After 20 years of using three primary doses of Hib vaccine without a booster Hib transmission continues in The Gambia, albeit at low rates. Improved coverage and timeliness of vaccination are of high priority for Hib disease in settings like Gambia, and there are currently no clear indications of a need for a booster dose.

引用

页数：12

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