Epidemiology of invasive Haemophilus influenzae infections in Cape Town, South Africa.
The full spectrum of invasive Haemophilus influenzae disease has not been documented previously in Africa. This 1-year prospective study was designed to determine the epidemiology of invasive Haemophilus influenzae disease in Cape Town children. During this period, 142 children with invasive disease were hospitalized; 85 (59.9%) presented with meningitis, 35 (24.6%) with pneumonia and 22 (15.5%) with other diseases. No cases of epiglottitis were seen. Sixty per cent of cases were male and 40% female. The median age of the children was 9 months, with a range of 1-144 months, and 65.5% were aged < 12 months. Neurological dysfunction was noted in 40% and 18% of children with meningitis on admission and discharge, respectively. The overall case fatality rate (95% confidence intervals) was 9.2% (4.9-15.7), and for meningitis, pneumonia and septicaemia it was 4.7% (1.2-16.4), 14.3% (4.6-31.8) and 40% (8-78.1), respectively. Serotype b accounted for 86.5% of all cases, 97.3% of cases of meningitis, 71.4% of cases of pneumonia, 50% of cases of septicaemia, all cases of arthritis and cellulitis and none of mastoiditis. The incidence rates (95% confidence intervals) for all invasive type b infections were 169 (122-198) and 47 (39-57) per 100,000 population for children < 1 and < 5 years, respectively. For meningitis the rates were 112 (84-148) and 34 (25-40) per 100,000, respectively. Rates for mixed race and white children were similar, but those for black children were more than double those rates.(ABSTRACT TRUNCATED AT 250 WORDS)
Hussey
G
G
Department of Paediatrics and Child Health, University of Cape Town, South Africa.
Hitchcock
J
J
Schaaf
H
H
Coetzee
G
G
Hanslo
D
D
van Schalkwyk
E
E
Pitout
J
J
Clausen
J
J
van der Horst
W
W
D017677:Age Distribution; D001168:Arthritis / Q000453:epidemiology / Q000382:microbiology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000208:ethnology / Q000382:microbiology / Q000401:mortality; D006193:Haemophilus influenzae / Q000145:classification; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D008297:Male; D011014:Pneumonia / Q000453:epidemiology / Q000382:microbiology; D011446:Prospective Studies; D044469:Racial Groups; D012621:Seasons; D012703:Serotyping; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology