Need for Haemophilus influenzae type b vaccination in Asia as evidenced by epidemiology of bacterial meningitis.
OBJECTIVE
To evaluate the role of Haemophilus influenzae type b (Hib) infections in Asia by scrutinizing data on Hib meningitis.


METHODS
A comprehensive literature search was performed in English and other languages. Special attention was paid to the age group of 0 to 4 years, in which the great majority of Hib meningitis occurs.


RESULTS
Twenty studies from as many countries indicated Hib to be a major pathogen in childhood meningitis. In series comprising nearly 2000 patients, Hib was responsible for at least 50% of cases in one-third of series and for at least 25% in three-fourths of series investigated and was the leading pathogen overall. The countries in South and Southeast Asia differed from the Middle East and East Asia in having a greater incidence of meningitis during the first 6 months of life; the proportions were 50 to 60% vs. 10 to 30%, respectively (P < 0.001).


CONCLUSIONS
Despite lacking data from many areas, belief in a paucity of Hib disease in Asia is not supported by the existing data; and because meningitis represents only 50 to 75% of all classical Hib manifestations and some cases occur after the age of 4 years, vaccination is warranted. The cumulative age curves suggest that conjugates with good immunogenic potential should be used, especially in South and Southeast Asia.
HUCH Hospital for Children and Adolescents, University of Helsinki, Finland.
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Peltola
D001208:Asia / Q000453:epidemiology; D002675:Child, Preschool; D006192:Haemophilus Infections / Q000453:epidemiology / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D019741:Haemophilus influenzae type b / Q000276:immunology*; D006801:Humans; D007223:Infant; D008583:Meningitis, Haemophilus / Q000453:epidemiology* / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data; D018074:Vaccines, Conjugate / Q000008:administration & dosage
D018073:Haemophilus Vaccines; D018074:Vaccines, Conjugate