Muganga N., Uwimana J., Fidele N., Gahimbare L., Gessner B.D., Mueller J.E., Mhlanga B.R., Katsande R., Herbinger K.-H., Rugambwa C.
Ministry of Health, Expanded Programme on Immunization, Kigali, Rwanda; Centre Hospitalier Universitaire de Kigali, Rwanda; Agence de Médecine Préventive à l'Institut Pasteur, Rue du Docteur Roux 28, 75015 Paris, France; Regional Office for Africa, World Health Organization, Harare, Zimbabwe; World Health Organization, National Office, Kigali, Rwanda
Muganga, N., Centre Hospitalier Universitaire de Kigali, Rwanda; Uwimana, J., Centre Hospitalier Universitaire de Kigali, Rwanda; Fidele, N., Ministry of Health, Expanded Programme on Immunization, Kigali, Rwanda; Gahimbare, L., Centre Hospitalier Universitaire de Kigali, Rwanda; Gessner, B.D., Agence de Médecine Préventive à l'Institut Pasteur, Rue du Docteur Roux 28, 75015 Paris, France; Mueller, J.E., Agence de Médecine Préventive à l'Institut Pasteur, Rue du Docteur Roux 28, 75015 Paris, France; Mhlanga, B.R., Regional Office for Africa, World Health Organization, Harare, Zimbabwe; Katsande, R., Regional Office for Africa, World Health Organization, Harare, Zimbabwe; Herbinger, K.-H., Agence de Médecine Préventive à l'Institut Pasteur, Rue du Docteur Roux 28, 75015 Paris, France; Rugambwa, C., World Health Organization, National Office, Kigali, Rwanda
Rwanda introduced Haemophilus influenzae type b (Hib) conjugate vaccine in January 2002 and simultaneously implemented pediatric bacterial meningitis surveillance at a major referral hospital in the capital Kigali. We reviewed clinical and laboratory information collected during January 2002 to June 2006. Due to a variety of laboratory limitations, only eight confirmed Hib cases were identified, all before 2004. However, the proportion of cerebrospinal fluid with purulence decreased from 26.0% during 2002, to 15.9% during 2003, 9.7% during 2004 and 8.4% in 2005 (p < 0.001). Vaccine effectiveness of two or three doses of Hib vaccine against purulent meningitis was 52% (95% confidence interval, 5-75%). In an African setting with few resources and in which few confirmed Hib meningitis cases were identified, Hib vaccine impact nevertheless could be demonstrated against the outcome of purulent meningitis and was found to be high. © 2007 Elsevier Ltd. All rights reserved.
antiretrovirus agent; diphtheria pertussis tetanus vaccine; Haemophilus influenzae type b vaccine; article; bacterial meningitis; cerebrospinal fluid; confidence interval; controlled study; diphtheria; drug efficacy; hospital; human; infant; major clinical study; pertussis; preschool child; priority journal; Rwanda; tetanus; Child, Preschool; Haemophilus influenzae type b; Haemophilus Vaccines; Humans; Infant; Meningitis, Haemophilus; Polysaccharides, Bacterial; Population Surveillance; Rwanda; Treatment Outcome; Vaccines, Conjugate