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Estimating the Haemophilus influenzae type b (Hib) disease burden and the impact of Hib vaccine in Fiji.
Vaccine. 2003 May 16; 21(17-18):1907-12.V

Abstract

AIMS

To estimate Haemophilus influenzae type b (Hib) disease burden in Fiji in children under the age of 5 years (under-5s) prior to vaccine introduction. To compare estimates from WHO's Hib rapid assessment tool (RAT), with that from decline in disease after vaccine introduction.

METHODS

Laboratory data (meningitis), hospitalization and mortality data (pneumonia and meningitis) before and after Hib vaccine introduction were collected. The RAT protocol provides two independent estimates of pre-vaccine disease burden (one based on meningitis incidence laboratory data and the other based on mortality statistics). A third estimate uses the decline in disease following vaccine introduction.

RESULTS

The decline in meningitis hospitalizations implies a pre-vaccine Hib meningitis incidence of 66 per 100,000 in under-5s. This compares with a pre-vaccine RAT estimate of Hib meningitis incidence of 84 per 100,000 (for 1992-1993). The RAT estimated the total annual pre-vaccine Hib burden (meningitis plus pneumonia) at 476 cases and 36 deaths per year ("meningitis incidence method") and 70 cases and 5 deaths ("child mortality method"). Hib vaccine led to declines of 32% (95% confidence interval (CI)=11-48%), and 78% (95% CI=22-94%) for all under-5s meningitis hospitalizations and deaths, respectively. There was no similar consistent decline in pneumonia hospitalizations or deaths after vaccine introduction, except for a statistically significant reduction in pneumonia mortality in children aged under 1 year.

CONCLUSIONS

Hib disease constitutes an important burden on the health of Pacific children that can be rapidly reduced with Hib vaccine. In this setting, routine morbidity statistics (comparing pre-and post-vaccine) provided an estimate of Hib meningitis burden which is broadly similar to that of the Hib RAT, suggesting that both might be valid ways to estimate Hib meningitis incidence. However, Hib pneumonia burden could not be estimated from routine statistics.

Authors+Show Affiliations

367a Karori Road, Karori, Wellington, New Zealand. nwilson@actrix.gen.nzNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12706676

Citation

Wilson, Nick, et al. "Estimating the Haemophilus Influenzae Type B (Hib) Disease Burden and the Impact of Hib Vaccine in Fiji." Vaccine, vol. 21, no. 17-18, 2003, pp. 1907-12.
Wilson N, Mansoor O, Wenger J, et al. Estimating the Haemophilus influenzae type b (Hib) disease burden and the impact of Hib vaccine in Fiji. Vaccine. 2003;21(17-18):1907-12.
Wilson, N., Mansoor, O., Wenger, J., Martin, R., Zanardi, L., O'Leary, M., & Rabukawaqa, V. (2003). Estimating the Haemophilus influenzae type b (Hib) disease burden and the impact of Hib vaccine in Fiji. Vaccine, 21(17-18), 1907-12.
Wilson N, et al. Estimating the Haemophilus Influenzae Type B (Hib) Disease Burden and the Impact of Hib Vaccine in Fiji. Vaccine. 2003 May 16;21(17-18):1907-12. PubMed PMID: 12706676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimating the Haemophilus influenzae type b (Hib) disease burden and the impact of Hib vaccine in Fiji. AU - Wilson,Nick, AU - Mansoor,Osman, AU - Wenger,Jay, AU - Martin,Rebecca, AU - Zanardi,Lynn, AU - O'Leary,Michael, AU - Rabukawaqa,Vilikesa, PY - 2003/4/23/pubmed PY - 2004/1/22/medline PY - 2003/4/23/entrez SP - 1907 EP - 12 JF - Vaccine JO - Vaccine VL - 21 IS - 17-18 N2 - AIMS: To estimate Haemophilus influenzae type b (Hib) disease burden in Fiji in children under the age of 5 years (under-5s) prior to vaccine introduction. To compare estimates from WHO's Hib rapid assessment tool (RAT), with that from decline in disease after vaccine introduction. METHODS: Laboratory data (meningitis), hospitalization and mortality data (pneumonia and meningitis) before and after Hib vaccine introduction were collected. The RAT protocol provides two independent estimates of pre-vaccine disease burden (one based on meningitis incidence laboratory data and the other based on mortality statistics). A third estimate uses the decline in disease following vaccine introduction. RESULTS: The decline in meningitis hospitalizations implies a pre-vaccine Hib meningitis incidence of 66 per 100,000 in under-5s. This compares with a pre-vaccine RAT estimate of Hib meningitis incidence of 84 per 100,000 (for 1992-1993). The RAT estimated the total annual pre-vaccine Hib burden (meningitis plus pneumonia) at 476 cases and 36 deaths per year ("meningitis incidence method") and 70 cases and 5 deaths ("child mortality method"). Hib vaccine led to declines of 32% (95% confidence interval (CI)=11-48%), and 78% (95% CI=22-94%) for all under-5s meningitis hospitalizations and deaths, respectively. There was no similar consistent decline in pneumonia hospitalizations or deaths after vaccine introduction, except for a statistically significant reduction in pneumonia mortality in children aged under 1 year. CONCLUSIONS: Hib disease constitutes an important burden on the health of Pacific children that can be rapidly reduced with Hib vaccine. In this setting, routine morbidity statistics (comparing pre-and post-vaccine) provided an estimate of Hib meningitis burden which is broadly similar to that of the Hib RAT, suggesting that both might be valid ways to estimate Hib meningitis incidence. However, Hib pneumonia burden could not be estimated from routine statistics. SN - 0264-410X UR - https://www.unboundmedicine.com/medline/citation/12706676/Estimating_the_Haemophilus_influenzae_type_b__Hib__disease_burden_and_the_impact_of_Hib_vaccine_in_Fiji_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264410X02008253 DB - PRIME DP - Unbound Medicine ER -