Progress towards meningitis prevention in the conjugate vaccines era.
Acute bacterial meningitis is an important cause of morbidity and mortality among children less than five years old, Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis being the most important agents of bacterial meningitis in developing countries. The development of the conjugate vaccines in the beginning of the 90's, especially type b H. influenzae (Hib), and more recently the heptavalent pneumococcal and the serogroup C meningococcal vaccines, have contributed directly to changes in the epidemiological profile of these invasive diseases (direct effect) and of their carriage status (indirect effect). We review the impact of the Hib conjugate vaccine in Latin American countries, where this vaccine has been implemented, and the potential of pneumococcal and meningococcal conjugate vaccines for the reduction of meningitis worldwide. We also address constraints for the development and delivery of these vaccines and review new candidate state-of-the-art vaccines. The greatest challenge, undoubtedly, is to implement these vaccines worldwide, especially in the developing regions.
Laval
Cristina Aparecida Borges
CA
Secretariat of Health, Municipality of Goiânia, Institute of Tropical Pathology and Public Health, Goiânia, GO, Brazil.
Pimenta
Fabiana Cristina
FC
de Andrade
João Guimarães
JG
Andrade
Soraya S
SS
de Andrade
Ana Lucia S S
AL
D016667:Bacterial Capsules; D001428:Bacterial Vaccines / Q000627:therapeutic use*; D002648:Child; D018073:Haemophilus Vaccines / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007843:Latin America / Q000453:epidemiology; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000627:therapeutic use; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D011135:Polysaccharides, Bacterial / Q000627:therapeutic use; D018074:Vaccines, Conjugate / Q000627:therapeutic use
D001428:Bacterial Vaccines; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial; D018074:Vaccines, Conjugate