Daza P., Banda R., Misoya K., Katsulukuta A., Gessner B.D., Katsande R., Mhlanga B.R., Mueller J.E., Nelson C.B., Phiri A., Molyneux E.M., Molyneux M.E.
Mzuzu Central Hospital, Mzuzu, Malawi; World Health Organization, Lilongwe, Malawi; Queen Elizabeth Central Hospital, Blantyre, Malawi; National EPI Programme, Ministry of Health, Lilongwe, Malawi; Agence de Médecine Préventive a l'Institut Pasteur, 28 rue du Docteur Roux, 75015 Paris, France; African Regional Office, World Health Organization, Harare, Zimbabwe; World Health Organization, Geneva, Switzerland; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi; Paediatrics Department, College of Medicine, Blantyre, Malawi
Daza, P., Mzuzu Central Hospital, Mzuzu, Malawi; Banda, R., World Health Organization, Lilongwe, Malawi; Misoya, K., Queen Elizabeth Central Hospital, Blantyre, Malawi; Katsulukuta, A., National EPI Programme, Ministry of Health, Lilongwe, Malawi; Gessner, B.D., Agence de Médecine Préventive a l'Institut Pasteur, 28 rue du Docteur Roux, 75015 Paris, France; Katsande, R., African Regional Office, World Health Organization, Harare, Zimbabwe; Mhlanga, B.R., African Regional Office, World Health Organization, Harare, Zimbabwe; Mueller, J.E., Agence de Médecine Préventive a l'Institut Pasteur, 28 rue du Docteur Roux, 75015 Paris, France; Nelson, C.B., World Health Organization, Geneva, Switzerland; Phiri, A., Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi; Molyneux, E.M., Paediatrics Department, College of Medicine, Blantyre, Malawi; Molyneux, M.E., Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi
Malawi has extreme poverty and a high-human immunodeficiency virus (HIV) prevalence. Following Haemophilus influenzae type b (Hib) conjugate vaccine introduction during 2002, we evaluated vaccine impact by reviewing hospital surveillance data for acute bacterial meningitis in Blantyre district among children age 1-59 months admitted during 1997-2005. Documented annual Hib meningitis incidence rates decreased from 20-40/100,000 to near zero among both rural and urban residents despite no change in pneumococcal meningitis incidence rates. Before vaccine introduction, an average of 10 children/year had Hib meningitis and HIV infection compared to 2/year during 2003-2004 and none during 2005. Vaccine effectiveness was high following two or more doses of vaccine. The most urgent future need is for a sustainable routine infant immunization program, including a less expensive vaccine that preferably is delivered in a multivalent form. © 2006 Elsevier Ltd. All rights reserved.