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Haemophilus influenzae Type b Conjugate Vaccine Introduction in Mali: Impact on Disease Burden and Serologic Correlate of Protection

2009; American Society of Tropical Medicine and Hygiene; Volume: 80; Issue: 6 Linguagem: Inglês

10.4269/ajtmh.2009.80.1033

1476-1645

Samba O. Sow, Milagritos D. Tapia, Souleymane Diallo, Mamadou Marouf Keita, Mariam Sylla, Uma Onwuchekwa, Marcela F. Pasetti, Karen L. Kotloff, M. M. Levine,

Bacterial Infections and Vaccines

In Bamako, Mali, where surveillance revealed a high incidence of Haemophilus influenzae type b (Hib) invasive disease, Hib conjugate vaccine was introduced into the Expanded Program on Immunization and the impact assessed. Annual confirmed Hib hospitalizations for infants 0–11 months of age fell from 175/10 5 to 44/10 5 ( P < 0.001); among infants 6–7 months of age Hib hospitalizations fell from 377/10 5 to 69/10 5 , (82% decrease, P < 0.001). Invasive Streptococcus pneumoniae hospitalizations remained unchanged. In a baseline serosurvey, only 3/200 infants 6–7 months of age (1.5%) had protective anti-polyribosylribitol phosphate (PRP) titers ≥ 0.15 μg/mL and 1(0.5%) had ≥ 1.0 μg/mL. In serosurveys 18 and 30 months after vaccine introduction, 168/201 (84%) and 184/200 (92%) infants, respectively, had titers ≥ 0.15 μg/mL and 141/201 (70%) and 163/200 (82%) had titers ≥ 1.0 μg/mL. Introduction of Hib vaccine led to rises in anti-PRP seroprevalence, significant reductions in Hib disease, and all-cause hospitalizations, whereas S. pneumoniae disease remained unchanged.