The increasing burden of disease in Bangladeshi children due to Haemophilus influenzae type b meningitis.
A laboratory-based study of diagnosed bacterial meningitis in the national paediatric hospital identified 852 cases of meningitis in the 8-year period 1987-1994. There were 587 culture-positive cases, of which Haemophilus influenzae (47%) and Streptococcus pneumoniae (32%) accounted for 80%. H. influenzae showed a remarkable increase of 700% during the study period. Most of the H. influenzae cases (90%) occurred in the 1st 2 years of life. Analysis of culture-negative specimens by antigen detection in the last 2 years also revealed the predominance of H. influenzae (71.4%) and S. pneumoniae (22.4%). Typing of H. influenzae isolates during this time showed that 98% of the strains were type b. This retrospective hospital-based study indicated a pronounced increase in the incidence of H. influenzae meningitis and strongly supports the need for large-scale Hib vaccination for young children. However, such nationwide intervention will probably need to be based on a prospective on a prospective and population-based surveillance of H. influenzae infections.
Saha
S K
SK
Department of Microbiology, Bangladesh Institute of Child Health, Dhaka Shishu (Children's) Hospital, Dhaka, Bangladesh.
Rikitomi
N
N
Ruhulamin
M
M
Watanabe
K
K
Ahmed
K
K
Biswas
D
D
Hanif
M
M
Khan
W A
WA
Islam
M
M
Matsumoto
K
K
Nagatake
T
T
D017677:Age Distribution; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000382:microbiology; D008583:Meningitis, Haemophilus / Q000134:cerebrospinal fluid / Q000382:microbiology; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid / Q000382:microbiology; D011008:Pneumococcal Infections / Q000134:cerebrospinal fluid / Q000382:microbiology; D012189:Retrospective Studies